Effectiveness of Home-Based Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials.

Effectiveness of Home-Based Pulmonary Rehabilitation for Patients with Chronic Obstructive Pulmonary Disease: A Meta-Analysis of Randomized Controlled Trials.

Rehabil Nurs. 2013 Jun 18;
Liu XL, Tan JY, Wang T, Zhang Q, Zhang M, Yao LQ, Chen JX

PURPOSE: The pulmonary rehabilitation program has become a cornerstone in the management of patients with chronic obstructive pulmonary disease (COPD). Programs based in hospital and treatment facilities, however, are inconvenient and underutilized. A home-based program is a promising alternative, but studies of its effectiveness have yielded inconsistent results. The purpose of this study is to evaluate the impact of home-based pulmonary rehabilitation programs on health-related quality of life (HRQoL) and other health outcomes in patients with COPD. METHODS: Randomized controlled trials (RCTs) of home-based pulmonary rehabilitation programs published between February 1991 and February 2012 were retrieved from electronic databases (PubMed, Cochrane Library, Science Direct, China National Knowledge Infrastructure [CNKI], and Wanfang Database). Two reviewers independently assessed topical relevance and trial quality, extracted data for meta-analysis using the Review Manager v5.1 software, and contacted the original studies’ authors for additional information. FINDINGS: Eighteen trials, comprising 733 randomized patients, were included in the meta-analysis. COPD patients experienced significant relief in dyspnea status, measured by the Borg score (Fixed effects model, WMD = -0.92, 95% CI: -1.61~-0.23, p = .009) and baseline dyspnea index (BDI) (Fixed effects model, WMD = -1.77, 95% CI: -2.65~-0.89, p < .0001) after 12 weeks of home-based intervention. Home-based intervention also improved patients' HRQoL scores, measured by the Chronic Respiratory Questionnaire (CRQ) and St. George's Respiratory Questionnaire (SGRQ) (Fixed effects model, WMD = -11.33, 95% CI: -16.37~-6.29, p < .0001, SGRQ total scores after 12 weeks of intervention); exercise capacity (measured by the 6-minute walking distance test (6MWD) (Fixed effects model, WMD = 35.88, 95% CI: 9.38~62.38, p = .008, after 12 weeks of intervention); and pulmonary functions (measured by forced expiratory volume in one-second/forced vital capacity (FEV1 /FVC) [Random effects model, WMD = -10.72, 95% CI: -15.86~-5.58, p < .0001, after 12 weeks of intervention), as compared with the nonintervention control group; however, no statistically significant changes were seen in maximal workload, hospital admission, cost of care, or mortality between the two groups. CONCLUSIONS AND CLINICAL RELEVANCE: Home-based pulmonary rehabilitation programs represent effective therapeutic intervention approaches for relieving COPD-associated respiratory symptoms and improving HRQoL and exercise capacity. Rigorously designed, large-scale RCTs are still needed to identify an optimal standard home-based pulmonary rehabilitation program. HubMed – rehab

Test-Retest Reliability and Minimal Detectable Change Scores for Fitness Assessment in Older Adults with Type 2 Diabetes.

Rehabil Nurs. 2013 Jun 18;
Alfonso-Rosa RM, Del Pozo-Cruz B, Del Pozo-Cruz J, Sañudo B, Rogers ME

PURPOSE: To assess the intraclass correlation coefficients (ICCs) and to determine the minimal detectable change (MDC95 ) scores of the data for the Hand Grip Strength Test, the Chair Sit and Reach Test (CSRT), the Timed “Up and Go” (TUG) test, the 6-Minute Walk Test (6MWT) and 30 seconds Sit to Stand Test (30s-STS) test in older adults with type 2 NIDDM. DESIGN: Test-retest reliability. METHODS: Eighteen subject participated in two sessions (1 week apart), which included the different tests. FINDINGS: High ICCs (?0.92) were found for all tests. The MDC95 scores were as follows: 4.0 kg for Hand Grip Strength Tests, 7.5 cm for the right leg-CSRT, 9.0 cm for the left leg-CSRT, 1.0 second for the TUG test, 27 m for the 6MWT, and 3.3 repetitions for the 30s-STS test. CONCLUSIONS: All tests evaluated are reliable outcome measures for type 2 NIDDM patients. CLINICAL RELEVANCE: This study has generated novel MCD95 data, which will assist nursing practitioners in both prescribing the most beneficial exercise and interpreting posttreatment changes after rehabilitation in patients with T2DM. HubMed – rehab

Urinary Incontinence and Prostate Cancer: A Progressive Rehabilitation Program Design.

Rehabil Nurs. 2013 Jun 18;
Serdà BC, Marcos-Gragera R

PURPOSE: To design and implement a rehabilitation program based on pelvic floor muscle training (PFMT) to improve the urinary incontinence (UI). METHODS: This study is based on a randomized clinical trial. The sample was formed by 66 participants with prostate cancer. The intervention groups were randomized into an experimental group (EG) and a control group (CG). The variables studied are: waist perimeter, variables related to the evolution of UI, muscular strength, and quality of life (QoL). Measurements were taken in order to evaluate changes in both groups. A statistical analysis was conducted using the Student-Fisher t-test, the Mann-Whitney-Wilcoxon test, and the chi-square test. FINDINGS/CONCLUSIONS: After 24 weeks an improvement was identified in the EG compared with the CG, in waist perimeter (p?.001), variables related to the UI symptom, intensity, frequency, difficulty and limitation of activity (p?.0001). A correlation between UI and QoL was observed (p=.039). CLINICAL RELEVANCE: The improvement in QoL is mediated indirectly by the improvement in the UI symptom. HubMed – rehab

Long-Term Effects of Safe Patient Handling Program on Staff Injuries.

Rehabil Nurs. 2013 Jun 18;
Theis JL, Finkelstein MJ

PURPOSE: This study evaluated the effectiveness of a safe patient handling program (STEPS) at an inpatient rehabilitation unit in reducing injury due to patient transfers. Our objectives were to compare number of staff injuries during the 1.5-year period post training to pre training (baseline) and to determine whether reduction in injuries was sustained long term during a 2.5-year post training period. METHODS: All nursing and therapy staff as well as new hires received STEPS training. Periodic retraining was not provided. FINDINGS: The number of injuries was significantly reduced at post training compared to baseline (p = 0.01). However, the reductions in injuries were not sustained long term. CONCLUSION: We estimated a cost benefit of $ 3.71 for every dollar invested in retraining based on injury reduction realized during the post training period. CLINICAL RELEVANCE: Retraining is likely to have a positive cost benefit when it results in maintaining reduction in staff injuries. HubMed – rehab

Drug/Alcohol Information and Support Introduction – Just a heads up, I hadn’t slept in 28 hours when I recorded this Lol. My college is physically taxing sometimes and my classes are all guiding me to graduate…