Résumé :
|
Introduction : The BODE index shows that the BPCO final pronostic is linked to a decrease in VEMS, to the intensity of dyspnea, to the distance walked during the six-minute test, and to a low body mass index. The aim of the physical reconditioning on a BPCO patient is to improve vital prognostic thanks to an increase in effort resistance. The latter being tested through the distance walked during the six-minute test, and the reduction of the dyspnea feeling. It is also indirectly linked to the improvement of quality of life, and to a decrease in the health costs (thanks to a decrease in morbidity, and in the number of hospitalized days) Patients and Methods : A retrospective study led on a test case had been carried out on an initial cohort of 30 patients, under home mechanical ventilationst group of 15 patients with respiratory assistance but without physical training; and another group of 15 patients, undergoing training for physical resistance : cycling, walking, a specific training for muscular fortification, and breathing exercises. These patients have been tested through : a six-minute walking test, the St. George questionnaire, SF-36 questionnaire, and the rate of lactic acid during effort and rest time, and EVA of dyspnea. Comparison of 15 patients of 73±10 years old and of BMI equal to 27±10,4 kg/m2 to an experimental group of 15 patients of 64 ± 10 years old, and of BMI equal to 34 ± 10 kg/m2. There is a significant difference in the age variable between the two groups, but the difference in BMI is considered insignificant in the experiment. Comparison between test group and experimental group : * p > 0,05 par test de t de student. Statistical results were obtained thanks to the ANCOVA test, as a function of age and BMI, because these two variables had high potential influence on the results. An early physical reconditoning is beneficial to the patients suffering from CRD, without cardio-vascular contraindication to physical efforts in order to increase time between two exacerbations and lower the costs. To make this program efficient, patients must stick to the recommendations in order to get an expected benefit close to the benefit obtained with patients suffering from chronic respiratory disease and not exacerbated. Griffiths TL, BurrML, Campbell IA,. Results at 1 year of out patient multidisciplinary pulmonary rehabilitation : a randomised controlled trial. Lancet. 2000 Jan 29;355(9201) :362-368.
|