Home-Based Pulmonary Rehabilitation in Moderate and Severe COPD Patients in Samutsakhon Hospital : A Prospective Experimental Study
Keywords:
6-min walk test (6MWT), chronic obstructive pulmonary disease (COPD), pulmonary rehabilitation (PR)Abstract
Objective: To study the effectiveness of home-based pulmonary rehabilitation in COPD patients on physical capacity using 6 minute walk test (6MWT), functional performance using mean scores of St. George’s Respiratory Questionaire (SGRQ) and spirometry results, and risk factors for acute exacerbation in COPD patients using modified Medical Research Council dyspnea scale (mMRC) and COPD assessment test (CAT) score .
Methods: This is a prospective experimental study by collecting data from history taking and data recording of COPD patients at the COPD clinic, along with 6MWT examination with the rehabilitation medicine team, Samutsakhon Hospital, and teaching how to continue physical therapy at home, together with the results of lung function tests by spirometry in March 2025 and 12 weeks later.
Results: Eighty-two COPD patients who visited the COPD clinic, Samutsakhon Hospital, 62 were male (83.8%); had an average age of 68.55 ± 9.76 years, an average weight of 61.3 ± 14.5 kilograms, and an average BMI of 23.21 ± 5.42 kilograms/square meter. Fifty COPD patients received home-based pulmonary rehabilitation, and 24 were in the control group. Both groups had similar basic information, such as age, gender, weight, severity of COPD, comorbidities, and results of lung function tests by spirometry.
COPD patients who did home-based pulmonary rehabilitation (PR) had a statistically significant increase in walking distance (meters) compared to the control group at the end of the program (p-value < .001; 95% CI: -72, -32.8). The difference in blood oxygen level in the group who did home-based PR was statistically significantly less than the control group (p-value < .01; 95% CI: 0.3%, 1.9%). In addition, the SGRQ scores in the group who did home-based PR in all three sections, including symptoms, activities, and impacts, decreased more than in the control group (p-value < .05). The total score of SGRQ, it was found that the group that did home-based PR had a significantly higher decrease than the control group (p-value < .001). The difference in the total score was 1.9 ± 8 in the control group and -6.7 ± 9.8 in the intervention group (p ≤ .001; 95% CI: 3.9, 13.1). Moreover the results of the spirometry showed that the difference in %predicted FEV1, %predicted FEV1/FVC, and %predicted FEF25-75 before and after home-based PR were significantly better than the control group (p-value < .001).
Conclusion: Home-based PR program is a good and easy way to exercise. It helps moderate and severe COPD patients have a better quality of life. They can do their daily activities by themselves. If there is support for regular exercise, it will result in the ability to exercise and increase muscle groups in the future.
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แผนกกายภาพบำบัด สถาบันโรคทรวงอก กรมการแพทย์ กระทรวงสาธารณสุข. แนวทางการให้การรักษาทางกายภาพบำบัดในผู้ป่วยโรคปอดอุดกั้นเรื้อรัง [อินเทอร์เน็ต]. 2559 [เข้าถึงเมื่อ วันที่ 23 มีนาคม พ.ศ. 2567]; เข้าถึงได้จาก: URL: https://www.ccit.go.th/lung/document/COPD+Home.pdf
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
