Article

The effect of rehabilitation for chronic obstructive pulmonary disease
has been well-documented in randomized controlled trials. Evidence-based
guidelines support rehabilitation programmes for chronic obstructive pulmonary
disease, but knowledge of their outcome in clinical practice is limited. The aim of this study was to assess the outcome of a clinical routine rehabilitation
programme for chronic obstructive pulmonary disease implemented by a Danish
regional hospital. METHODS: Changes in walk-distance (6-min
walk-distance test; 6MWD), dyspnoea (Medical Research Council dyspnoea scale;
MRC) and health-related quality of life (Short-Form 36; SF-36) were compared
between and within completers and non-completers from baseline to the end of
clinical routine rehabilitation, and at 6 and 12 months. The 8-week clinical
routine rehabilitation comprised bi-weekly 90-min sessions of patient education
and physical training. RESULTS: The hospital treated 521 patients during the
study period. Of these, 175 were invited to join the study, 148 participated at
baseline, and 98 at the 12-month follow-up. Completers' 6MWD was sustained from
baseline to the end of clinical routine rehabilitation, but had declined by 12
months. Dyspnoea and health-related quality of life did not change. Seventy-five
percent of completers felt better or much better after rehabilitation.
CONCLUSION: The failure of completers to achieve expected outcomes shows a need
for a stronger implementation effort and continuous quality control. Successful
implementation in clinical routine requires targeted recruitment and overall programme improvement in general, and a stronger focus on physical training and
staff competences.

Langue : ANGLAIS