The Effect of Respiratory Rehabilitation for the Frail Elderly: a Pilot Study

Abstract

Objective: To analyze the effects of respiratory rehabilitation on the activities of daily living (ADL) and quality of life (QOL) in community-dwelling frail elderly.Design: Pilot intervention study after a one-year period of observation.Setting: Day care facility in a rehabilitation hospital.Subjects: Thirty community-dwelling frail elderly using rehabilitation services Intervention: After a one-year observation period of usual rehabilitation, 30 participants were given 12 rehabilitation sessions that included respiratory rehabilitation (three sessions a week for four weeks). Journal of General and Family Medicine 2016, vol. 17, no. 4, p. 289-298. Original Articles -289 -evaluation), prior to training (pre-training evaluation), and after the sessions (post-training evaluation). Primary outcome measures included: respiratory function, swallowing function, ADL, and QOL. Secondary outcome measures included: depressive score, exercise tolerance, 6-minute walk distance, thorax flexibility, and muscle strength (knee extension, grip, and abdominal). QOL were estimated using questionnaires.Results: Swallowing function, ADL, QOL (SF8 physical and mental summary score), respiratory function, and physical function were significantly reduced during usual rehabilitation (between the initial evaluation and pre-training evaluation), whereas swallowing function, ADL, QOL (SF8 physical component summary score [PCS]), respiratory function, exercise tolerance, 6-minute walk distance, thorax flexibility, and muscle strength (knee extension) were significantly improved during respiratory rehabilitation (between the pre-training evaluation and post-training evaluation). Conclusions:Our results suggest that a usual rehabilitation program without respiratory training is not sufficient for the frail elderly to maintain their ADL and QOL, and furthermore that respiratory rehabilitation can help improve their ADL and QOL as well as their swallowing and respiratory function.

Factors related to physical and mental components of quality of life in the community-dwelling frail older persons

“…Rosińczuk 2 ) and colleagues reported that while QOL of patients with COPD is not affected by gender, decline in QOL level is associated with age and pulmonary function. In the present study, the participants did not include those with COPD; however, in our previous studies, we reported that pulmonary function decreased in community-dwelling frail older persons even without COPD and also showed an association between pulmonary function and ADL/QOL 13 , 14 ) .…”

“…In the present study, the participants did not include those with COPD; however, in our previous studies, we reported that pulmonary function decreased in community-dwelling frail older persons even without COPD and also showed an association between pulmonary function and ADL/QOL 13,14) .…”

Effect of pulmonary training for community‐dwelling frail older adults with chronic stroke: A randomized controlled pilot trial

“…The inclusion criteria included the following: history of stroke diagnosed by clinicians and needing rehabilitation, more than 65 years of age, 6 months since acute disease onset, and period since stroke onset of >6 months, and being in a physical condition that can be described as “frail” as defined by the Fried Frailty Criteria (Cardiovascular Health Study: CHS index) 13 . Participants who could not use an auto spirometer or with moderate or severe cardiac disease (New York Heart Association 14 Classification of III or IV) 7,15 were excluded from the study.…”

“…For the intervention group, each 20‐min rehabilitation session was held once a day and was made up of 10 mins of pulmonary training in addition to 10 min of standard rehabilitation 7,15 . The pulmonary training intervention comprised the following: pulmonary muscle training, stretching exercise, and home exercise 7,15,16 .…”

“…For home training, the intervention group used the positive expiratory pressure device to do pulmonary muscle training (3 sets of 10 repeats) and cough training (3 sets of 10 repeats, low‐intensity active coughs), pursed‐lip breathing (3 sets of 10 repeats) every day 7,15,21 . Instruction from the physiotherapist was done before the first session of home pulmonary training.…”