1998 OPEN FORUM Abstracts
CUSTOMIZED COMPREHENSIVE PULMONARY REHABILITATION
Penny Gagne Plouff, RRT Respiratory Rehabilitation & Therapy, P.A., Portland, Maine
Employed patients hesitate to commit to pulmonary rehabilitation programs offered during normal business hours. Respiratory Rehabilitation & Therapy, P.A. offers a program, which is privately operated by a registered respiratory therapist. The program offers flexible scheduling and has a maximum patient to staff ratio of 3:1. This low ratio allows the program to be customized to the specific needs of each patient. The flexibility of the program also allows class to be rescheduled due to illness or weather. The program works with both the primary care physician and pulmonologist for each patient. Chest Medicine Associates referred patients for pulmonary rehabilitation. The patients ranged from 47 to 64 years of age. All were diagnosed with severe COPD.
Appointments were scheduled twice a week for twenty-four sessions. The time frame to complete the program was variable between thirteen weeks and twenty-two weeks. Each two-hour session consisted of an educational topic and two to three exercise stations (for a minimum of thirty minutes of sustained exercise). Exercise stations included chair-based aerobics, upper body cycle, respiratory muscle training, treadmill, and recumbent bike. All exercise sessions were limited based on symptoms of shortness of breath (using the Rating of Perceived Exertion) and target heart rate. Two of the patients had brief hospitalizations during the program and resumed their appointments within days of discharge. One patient was placed on supplemental oxygen therapy during the program and successfully weaned to room air by completion of the program. One patient started the program as an active smoker and successfully became a nonsmoker several weeks before graduation from the program. Of the five patients who have now completed the program, three attended classes alone and two attended together. Figure 1 compares the initial six-minute walk study for each patient to the six-minute walk study at program completion. The average improvement was 97% over baseline distance. Initially, patients tolerated an average of thirty minutes of exercise. By completion of the program, the patients averaged fifty-five minutes of exercise per session. Three continue full-time employment, one has resumed part-time work, and the last has been cleared from housebound status by his physician. In conclusion, the patients made excellent progress in a private setting for comprehensive pulmonary rehabilitation. They are all currently following a regular exercise regimen of at least thirty minutes of exercise twice per week.
(See Original for Figure)
The 44th International Respiratory Congress Abstracts-On-Disk®, November 7 - 10, 1998, Atlanta, Georgia.