This study was aimed at identifying the effectiveness of hospital-based pulmonary rehabilitation programme as compared to home-based pulmonary programme in improving the condition of the chronic obstructive pulmonary disease (COPD) patients of Universiti Kebangsaan Malaysia Hospital. A total of 35 patients aging between 17 to 78 years old were randomised either to hospital (48.6%, n = 20) or home (43%, n = 15) -based pulmonary rehabilitation by the Physiotherapists. For the hospital-based rehabilitation programme, the patients were scheduled to come to the hospital twice a week for eight weeks. For home-based rehabilitation programme, subjects were scheduled to come to the Physiotherapy Department twice to learn on the exercises that need to be carried out before they are allowed to do on their own at home. Each subject was given a diary to record the exercises that have been done. A telephone call is made once a week for monitoring purpose. Assessment of lung function, six-minute-walk test and Borg score were carried out before and after the eight-week rehabilitation is conducted. The Results showed that there was no significant change in lung function for both groups before and after rehabilitation. There is a significant different (p < 0.05) in 6MWT before and after rehabilitation for hospital-based pulmonary rehabilitation patients. However, the difference is not significant (p > 0.05) for home-base pulmonary rehabilitation patients. The results also show that there exist no significant correlation between lung function and 6MWT even though there is an increase in walking distance at baseline or the eighth week. In conclusion, hospitalbased pulmonary rehabilitation is more effective than the home-based pulmonary rehabilitation in improving the exercise endurance which would helps in reduce dyspnoea among COPD patients.
Keywords: Home-based pulmonary programme; Hospital-based pulmonary programme; COPD; Lung function
Chronic Respiratory Questionnaire (CRQ) is one of the disease-specific questionnaires to assess health related quality of life (HRQoL) among chronic obstructive pulmonary disease (COPD) patients. Objectives: This study investigate the validity and reliability of Malay version CRQ among COPD patients. Methods: The CRQ was administered twice to 46 patients with COPD (mean FEV1 44% predicted, FEV1/ IVC 37% predicted) from Medical Center of University Kebangsaan Malaysia (PPUKM).Test-retest reliability was assessed using intra-class correlation coefficients (ICC). Internal consistency was determined using Crohnbach’s alpha coefficients (α = 0.7). Spearman’s correlation coefficient was done among the scores of CRQ, St George Respiratory Questionnaire (SGRQ) and six- minute walking test (6MWT) to examine the concurrent validity of the CRQ (p 0.70) was observed for 3 domains of CRQ with exception of dyspnoea domain (α = -0.631). Test retest reliability demonstrated strong correlation (ICC >0.80). Concurrent validity of CRQ, showed significant correlations observed between domain of SGRQ’s symptom, impact and total scores of SGRQ with CRQ’s dyspnoea and emotional function (-0.3< r < -0.4; p
BACKGROUND: This study was proposed to develop a composite of outcome measures using forced expiratory volume percentage of predicted, exercise capacity and quality of life scores for assessment of chronic obstructive pulmonary disease (COPD) severity.
MATERIALS AND METHODS: Eighty-six patients with COPD were enrolled into a prospective, observational study at the respiratory outpatient clinic, National University Hospital Malaysia (Hospital Universiti Kebangsaan Malaysia--HUKM), Kuala Lumpur.
RESULTS: Our study found modest correlation between the forced expiratory volume in 1 s (FEV(1)), 6 min walk distance and the SGRQ scores with mean (SD) values of 0.97 (0.56) litres/s, 322 (87) m and 43.7 (23.6)%, respectively. K-Means cluster analysis identified four distinct clusters which reached statistical significance which was refined to develop a new cumulative staging system. The SAFE Index score correlated with the number of exacerbations in 2 years (r = 0.497, p<0.001).
CONCLUSION: We have developed the SGRQ, Air-Flow limitation and Exercise tolerance Index (SAFE Index) for the stratification of severity in COPD. This index incorporates the SGRQ score, the FEV(1) % predicted and the 6 min walk distance. The SAFE Index is moderately correlated with the number of disease exacerbations.
Study site: Respiratory clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia