Authors (including presenting author) :
Wong SY (1), Li CM (1)
Affiliation :
Physiotherapy Department, KWH
Introduction :
Chronic obstructive pulmonary disease (COPD) is a common respiratory disease with high incidence rate and mortality (Traulsen et al.,2018). Effective management of the COPD is difficult due to its progressive and recurrent exacerbation nature. To improve the management of COPD patients, service gap of lacking a systematic approach in self-empowerment in disease management is identified. To fill the service gap, a condensed Pulmonary Rehabilitation Program lead by a physiotherapist in collaboration with the COPD nurse clinic was established in November 2019.
Objectives :
To empower COPD patients with knowledge and techniques for self-management including dyspneic management, airway clearance and stress management. Breathing exercise and control and exercise training was also given.
Methodology :
A 4- sessions condensed PRP was held biweekly from November 2019. Inclusion criteria was GOLD 1 or 2 and able to attend the classes by themselves. Patients who are cognitively impaired and with unstable medical and orthopedic conditions were excluded. The classes were divided into 2 parts. The first part was educational with various themes highlighted in each class: i) importance, benefits and types of exercise for COPD; ii) breathing control and exercise, dyspneic management; iii) airway clearance techniques and iv) stress management. The second part of each class Outcome measures: 1. 6 Minutes Walk Test (6MWT) 2. Modified Medical Research Council Dyspnea Scale (mMRC) 3. COPD Assessment Test (CAT)
Result & Outcome :
Four male patients with age 60 to 83 (mean 72.7) were recruited. Three patients completed whole program. Two patients shown improved 6MWT (30 & 33m), The mMRC were similar. All patients shown improvement in CAT (1-4 points, mean: 2.3 points). Upon post program evaluation, all patients express they had improved confidence in self-management of the disease. All of them agreed that they had gained knowledge in breathing control and exercise, sputum clearance, stress management and exercise. All of them expressed they had improved confidence in self-exercise and would maintain exercise habit post program. Conclusion: The results of the pilot condensed PRP suggested improved functional capacity and self-mastery of the disease in COPD patients. Further evaluation of the PRP with longer follow up and more patients would definitely provide information for quality improvement in the management of the COPD patients in the future.
