Abstract
Introduction: pulmonary rehabilitation is a multidisciplinary approach that improves symptoms and decreases the impact of lung disease in everyday activities. Objective: to determine the effect of a 4-phase pulmonary rehabilitation program, performed in an outpatient center, on exercise tolerance and quality of life in patients with obstructive, restrictive and pulmonary vascular disease. Materials and methods: prospective study in 57 patients that completed a 4-month pulmonary rehabilitation program. At the beginning and at the end of the program, a 6-minute walk and the Saint George quality of life test were carried out. For the evaluation of the difference of medians between groups, the non-parametric Wilcoxon test was used. Results: the median age was 69 years, 50.9% were female and after the program an increase in the distance traveled in the 6-minute walk was observed, with a difference of 15,6 meters (p=0,07). The Saint
George quality of life test at the end of the program showed a decrease in the symptoms domain [18,5% (p<0,01)], activity [4,1% (p<0,01)], impact [5,4% (p<0,01)] and total [7,6% (p<0,01)]. Discussion: it was evidenced that the respiratory pathologies achieve a stabilization of
symptoms with the pulmonary rehabilitation, findings congruent to those reported by other authors. Conclusion: pulmonary rehabilitation improves the exercise tolerance and the quality of life in terms of reduction of symptoms and the impact of the disease in patients with
pulmonary disease. MÉD.UIS. 2018;31(3):27-36.
References
Burden of Disease from 2002 to 2030. PLoS Med. 2006 Nov;
3(11): e442.
2. Masoli, M, Fabian, D, Holt, S, Beasley, R. The global burden
of asthma: executive summary of the GINA Dissemination
Committee Report. Allergy. 2004;59:469-478.
3. Montes M, López M, Acuña A, Schiavi E, Rey M, Jardim J., et al.
Guía de práctica clínica de la enfermedad pulmonar obstructiva
crónica (EPOC) ALAT-2014: Preguntas y respuestas. Arch
Bronconeumol. 2015;51(8):369-426.
4. Ciapponi A., Alison L, Agustina M, Demián G, Silvana C, Edgardo
S. The Epidemiology and Burden of COPD in Latin America and
the Caribbean: Systematic Review and Meta- Analysis. COPD.
2014;11(3):339-50.
5. Menezes A, Perez-Padilla R, Jardim JR, Muiño A, Lopez V,
Valdivia G, Montes M, et al. Chronic obstructive pulmonary
disease in five Latin American cities (the PLATINO study): a
prevalence study. Lancet. 2005;366(9500):1875–81.
6. Duran D, Vargas O. La enfermedad respiratoria crónica:
reflexiones en el contexto del sistema de salud colombiano. Rev.
Cienc. Salud. 2007;5(2):106-15.
7. Caballero A, Torres-Duque C, Jaramillo C, Bolívar F, Sanabria
F, Osorio P, et al. Prevalence of COPD in five colombian cities
situated at low, medium, and high altitude. (PREPOCOL Study).
CHEST. 2008;133(2)343-9.
8. Institute for Health Metrics and Evaluation (IHME). Disponible
en: http://www.healthdata.org/colombia.
9. Dennis RJ, Caraballo L, García E, Rojas MX, Rondón M, et al.
Prevalence of asthma and other allergic conditions in Colombia
2009–2010: a cross-sectional study. BMC Pulmonary Medicine.
2012;12:17. DOI: 10.1186/1471-2466-12-17.
10. Cuero D.F., Rosero-Carvajal H.E., Wilches-Luna E.C., Gutierrez
C.M. Entrenamiento de fuerza y resistencia muscular de
miembros superiores en pacientes con enfermedad respiratoria
crónica: Estudio de casos. Fisioterapia. 2014;36(3):143-7.
11. Vargas OC. Entrenamiento físico en enfermedad respiratoria
crónica. Rev. Cienc. Salud. 2003;1(2):180-89.
12. Nici L., ZuWallack RL. Pulmonary rehabilitation: Definition,
concept, and history. Clin Chest Med. 2014;35(2):279-82.
13. Guell MR, Diaz S, Rodriguez G, Morante F, San Miguel M. et al.
Pulmonary Rehabilitation. Arch Bronconeumol 2014; 50(8):332-
44.
14. Convenio OMS/OPS. Intervenciones para un programa de
rehabilitación pulmonar. MinSalud [Internet]. 2015. Disponible:
https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/
RIDE/VS/PP/ENT/rehabilitacion-pulmonar.pdf.
15. Mendes F, Goncalves R, Nunes M, Saraiva B, Cukier A, et al.
Effects of Aerobic Training on Psychosocial Morbidity and
Symptoms in Patients With Asthma. CHEST. 2010;138(2):331-
337
16. Hernández CM, Mejía R. Bases fisiológicas de la rehabilitación
pulmonar. Neumología y cirugía de tórax. 2005;64(2):72-78.
17. Cejudo P, Ortega F, Márquez E. Rehabilitación respiratoria.
Neumosur [Internet].[Consulta Julio 24 de 2018]. Disponible en:
https://www.neumosur.net/files/EB04-12%20rehabilitacion.pdf.
18. Riaño Y S, Valbuena L J, Aplicación de la caminata de 6
minutos en pacientes con enfermedad respiratoria cronica como
determinante de la utilidad de un programa de rehabilitacion
pulmonar. Umbral Científico [Internet] 2010(16):13-19. [Consulta
Abril 14 de 2018]. Disponible: http://www.redalyc.org/articulo.
oa?id=30418644003.
19. Rabinocich RA, Vilaro J, Roca J. Evaluación de la tolerancia al
ejercicio en pacientes con EPOC. Prueba de marcha de 6 minutos.
Arch Bronconeumol. 2004;40(2):80-5.
20. Rivadeneira MF. Validación del cuestionario respiratorio St.
George para evaluar calidad de vida en pacientes ecuatorianos
con EPOC. Rev Cuid. 2015;6(1): 882-91.
21. ATS Committee on Proficiency Standards for Clinical Pulmonary
Function Laboratories. ATS statement: guidelines for the sixminute
walk test. Am J Respir Crit Care Med. 2002;166(1):111-7.
22. Spruit M, Singh S, Garvey C, Zuwallack R, Nici L, Rochester C, et
al. An Official American Thoracic Society/European Respiratory
Society Statement: Key Concepts and Advances in Pulmonary
Rehabilitation. Am J Respir Crit Care Med. 2013;188(8):13-64.
23. Paz JJ, Vásquez I, Villamizar FL. Tolerancia al ejercicio y calidad
de vida en pacientes con enfermedad pulmonar obstructiva
crónica en un programa de rehabilitación pulmonar de cuatro
semanas. Rev Colombiana de Neumología. 2012:18(1):28-33.
24. Theander K, Jakobsson P, Jorgensen N, Unosson M. Effects
of pulmonary rehabilitation on fatigue, functional status
and health perpections in pacients with chronic obstructive
pulmonary disease: A randomized controlled trial. Clin Rehabil.
2009;23(2):125-36.
25. Súarez N, Cummings M, Vásquez YA. Entrenamiento de
resistencia, disnea y capacidad aeróbica en pacientes con
EPOC. Ensayo clínico aleatorizado. Rev Col Med Fis Rehab.
2013;23(1):48-58.
26. Sivori M. Rehabilitación respiratoria y exacerbaciones de EPOC:
¿una utopía hecha realidad?. RAMR. 2016;16(1):46-55.
27. Shahin B, Germain M, Pastene G, Viallet N, Guy A. Outpatient
pulmonary rehabilitation in patients wuth chronic obstructive
pulmonary disease. Int J Chron Obstruct Pulmon Dis.
2008;3(1):155-62.
28. Drozdowski J, Bakuła S, Drozdowska A, Kedziora K, Porzezińska
M, Słomiński JM. The effects of pulmonary rehabilitation on the
quality of life in patients with COPD. Pnumonol Alergol Pol.
2007;75(2):147-52.
29. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse
Y. Pulmonary rehabilitation for chronic obstructive pulmonary
disease. The Cochrane Database of Systematic Reviews 2015, Issue
2. Art. No.: CD003793. DOI: 10.1002/14651858.CD003793.pub3.
30. Foster S, Thomas M. Pulmonary rehabilitation in lung disease other tan Chronic Obstructive Pulmonary Disease. Am Rev Respir Dis. 1990;141(3)601-4.
31. Kallail KJ, Hope M, Nichols D. Pulmonary rehabilitation in
patients with respiratory disease. KS J Med. 2014;7(1):6-10.
32. Carson KV, Chandratilleke MG, Picot J, Brinn MP, Esterman AJ,
Smith BJ. Physical training for asthma. The Cochrane Database
of Systematic Reviews 2013 Sep 30, Issue 9. Art. No.:CD001116.
DOI: 10.1002/14651858.CD001116.pub3.
33. Barrios I, Maurenza G, Rivero M, Rodriguez A. Rehabilitación
respiratoria en pacientes asmáticos. Rev AMC [Revista en
internet]. 2000 [acceso agosto de 2011] 4(3). Disponible
en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid
=S1025-02552000000300006.
34. Meneses M. Programa de rehabilitación respiratoria en
pacientes asmásticos. Repercusió sobre las pruebas funcionales
respiratorias. Rev Cubana Med. 1999;38(3):178-82.
35. Freitas D, Holloway E, Bruno S, Chaces GS, Fregonezi GA,
Mendonça KP. Breathing exercises for adults with asthma. The
Cochrane Database of Systematic Reviews 2013 Oct 1, Issue 10.
Art. No.:CD001277. DOI: 10.1002/14651858.CD001277.pub3.
36. Turner S, Eastwood P, Cook A, Jenkins S. Improvements in
Symptoms and Quality of Life following Exercise Training
in Older Adults with Moderate/Severe Persistent Asthma.
Respiration. 2011;81(4):302–10.
37. Mendes F, Goncalces R, Nunes M, Saraiva B, Cukier A, et al.
Effects of Aerobic Training on Psychosocial Morbidity and
Symptoms in Patients With Asthma: A Randomized Clinical
Trial. CHEST. 2010;138(2):331-7.
38. Betancourt J, Hurtado H. Efectos de un programa de rehabilitación
pulmonar en pacientes con enfermedad pulmonar intersticial
difusa. Fisioterapia. 2015;37 (6):259-316.
39. Nishiyama O, Kondoh Y, Kimura T, Kato K, Kataoka K, et al.
Effects of pulmonary rehabilitation in patients with idiopathic
pulmonary fibrosis. Respirology. 2008;13(3):394-9.
40. Salhi B, Troosters T, Behaegel M, Joos G, Derom E. Effects
of pulmonary rehabilitation in patients with restrictive lung
diseases. CHEST. 2010;137(2):273-9.
41. Holland A, Hill C, Glaspole I, Gog N. Predictors of benefit
following pulmonary rehabilitation for interstitial lung disease.
Respir Med. 2012;106(3):429-35.
42. Kabitz H, Bremer H, Schwoerer A, Sonntag F, Walterspacher
S, et al. The combination of exercise and respiratory training
improves respiratory muscle fuction in pulmonary hypertension.
Lung. 2014;192(2):321-8.
43. Peña JB, Muñoz BE, Hurtado H. Efecto de la rehabilitación
pulmonar en la calidad de vida y la capacidad funcional en
pacientes con secuelas de tuberculosis. NOVA. 2015;13(24):47-54.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2018 Revista Médicas UIS