title: Use of functional independence measure in rehabilitation of inpatients with respiratory failure.
abstract: Most outcomes do not deeply express the degree of disability in patients with respiratory failure (RF) following inpatient pulmonary rehabilitation (IPR). The aim of our study was to evaluate the efficacy of an IPR in patients with confirmed COPD and RF using functional independence measure (FIM) that determines the degree of disability experienced by patients and the progress they make during rehabilitation. This scale includes several items: self care, mobility, locomotion, communication and social recognition. Twenty-two patients (age 70+/-2 years, PO(2) 58.18+/-7.63mmHg, PCO(2) 46.82+/-9.11mmHg) were prospectively observed and studied. IPR included respiratory and peripheral muscle training, mucus evacuation techniques, and energy conservation techniques. FIM, Medical Research Council dyspnoea scale (MRC), St. George's Respiratory Questionnaire (SGRQ), and 6-min walking distance (6-MWD) were assessed on admission (pre) and discharge (post) from IPR. After IPR there was a statistically significant improvement (p<0.01) in all the FIM items (total score in self care, mobility, locomotion, social recognition) except for communication. Changes of MRC (pre 4.32+/-0.84; post 3.00+/-1.15, p<0.001), SGRQ (%) (pre 69.86+/-4.62; post 46.50+/-11.94, p<0.001), and 6-MWD (pre 164.54+/-98.63; post 214.32+/-97.64, p<0.001) paralleled those improvements. An inverse correlation between MRC and FIM (r=-0.5042, p=0.016) was observed. Our preliminary study has shown that the benefits of IPR in COPD with RF do not only translate in dyspnoea, exercise capacity and quality of life but also within neuromotor disabilities as assessed by FIM. Our results warrant future studies in pulmonary rehabilitation using FIM as an outcome measure.
authors.affiliation: Centre of Pulmonary Medicine and Rehabilitation, San Raffaele-Velletri (Tosinvest Sanità), Rome, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Pasqua
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Biscione
authors.forename: Girolmina
authors.initials: G
authors.lastname: Crigna
authors.forename: Romana
authors.initials: R
authors.lastname: Gargano
authors.forename: Vittorio
authors.initials: V
authors.lastname: Cardaci
authors.forename: Luigi
authors.initials: L
authors.lastname: Ferri
authors.forename: Alfredo
authors.initials: A
authors.lastname: Cesario
authors.forename: Enrico
authors.initials: E
authors.lastname: Clini
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D004185:Disability Evaluation; D004417:Dyspnea / Q000534:rehabilitation; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000523:psychology / Q000534:rehabilitation*; D012648:Self Care; D018709:Statistics, Nonparametric; D014549:Urinary Incontinence