title: Tri-state region pulmonary rehabilitation survey. Delivery of exercise conditioning services. The Pulmonary Rehabilitation Committee, Tri-State Society for Cardiovascular and Pulmonary Rehabilitation.
abstract: OBJECTIVE
  This report analyzes the delivery of exercise conditioning services in the 1991 Pennsylvania, New Jersey, and Delaware regional survey of pulmonary rehabilitation programs.
  
  
  METHODS
  Data from a questionnaire was analyzed with special consideration given to whether the program provided services for patients with only pulmonary diseases (n = 41) or with cardiac and pulmonary diseases (n = 18).
  
  
  RESULTS
  All 59 programs included exercise conditioning. Most programs (67%) used oxygen saturation and/or expired gas analysis for writing exercise prescriptions. Only pulmonary programs used 6- or 12-minute walk data. The exercise prescription was written by nonphysicians in 51% of the programs. Most pulmonary-only programs used respiratory therapists by themselves or in combination with other professionals as exercise supervisors (71%). Cardiopulmonary programs used exercise physiologists by themselves (22%) or nurses by themselves or in combination with other professionals (50%). For all programs, the standard for ratio of patients to exercise staff averaged 3.0:1. Pulmonary-only programs did slightly but significantly more continuous arterial oxygen percent saturation (SaO2) monitoring rather than spot checking. A standard determining the use of supplemental oxygen during exercise was reported by 78% of all programs. Most used supplemental oxygen after observing the SaO2 level falling to < 90%. Electrocardiograph monitoring was done in 66% of pulmonary-only programs, but in 94% of the cardiopulmonary programs. Maintenance sessions were offered by 64% of the pulmonary-only programs and also by 78% of the cardiopulmonary programs.
  
  
  CONCLUSIONS
  The type of rehabilitation program, either pulmonary-only or cardiopulmonary, appears to influence the exercise conditioning services used by the pulmonary patient.
authors: Department of Medicine, Medical College of Pennsylvania and Hahnemann University, Philadelphia, USA.
authors: P C
authors: PC
authors: Weiser
authors: K P
authors: KP
authors: Ryan
mesh_terms: D003691:Delaware; D003695:Delivery of Health Care / Q000458:organization & administration*; D005080:Exercise Test; D005081:Exercise Therapy / Q000458:organization & administration*; D006302:Health Services Research; D006331:Heart Diseases / Q000534:rehabilitation*; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000534:rehabilitation*; D008991:Monitoring, Physiologic; D009515:New Jersey; D010414:Pennsylvania; D055656:Prescriptions; D012041:Regional Medical Programs; D011795:Surveys and Questionnaires