[Improvement of lasting effects in outpatient pulmonary rehabilitation with special regard to exercise therapy and sports].
BACKGROUND
The aim of this study was to evaluate the effects of outpatient medical rehabilitation (OMR) mainly composed of exercise therapy and sports for patients with asbestosis. Following the Hamburg model, the OMR focuses on keeping up lasting effects.


METHODS
In the frame of a pre-experimental study, 113 male asbestosis patients aged 66.1+/-5.8 years participated 6 hrs. a day five times a week over a period of three weeks in phase 1 of the OMR consisting of evidence-based contents of the pulmonary rehabilitation. Directly after that further therapeutic applications with the main focus on exercise therapy and sports were applied for 3 hrs. once a week over a period of twelve weeks (phase 2). After phase 2 the rehabilitation centre led the patients into sports groups near their places of residence (phase 3). The effects of the OMR were evaluated at the beginning (T1), at the end of phase 1 (T2) and phase 2 (T3) as well as 6 (T4) and 18 months (T5) after T3 by means of a suitable assessment.


RESULTS
Compared to T1 physical fitness (6-minute Walk Test, Hand-Force Test) as well as health-related quality of life (SF-36), dyspnea (BDI/TDI) and oxygen partial pressure (pO2) were significantly improved in T2. These positive effects could be confirmed in T3. 89 patients (79%) were doing health-related sports regularly 6 and 18 months after T3 and could preserve their health outcome in T4 and T5, while the effects of rehabilitation of the 24 patients breaking off any sporting activities wore off again down to and even below the starting condition at T1.


CONCLUSIONS
In spite of a restrictive pulmonary disease, specific exercise therapy and sports are able to mobilize physical reserves of performance and induce an increasing quality of life as well as a higher resilience in activities of daily living. These positive effects could be stabilized persistently by a regular training once a week. Thus, the results emphasize the necessity to include strategies of aftercare in the concept of rehabilitation.
Dalichau
S
S
Berufsgenossenschaftliche Unfall-Ambulanz und Reha-Zentrum am Airport Bremen, Bremen. sdalichau@ipl-bremen.de
Demedts
A
A
im Sande
A
A
Möller
T
T
D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D001195:Asbestosis / Q000175:diagnosis* / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D020127:Recovery of Function; D013177:Sports; D016896:Treatment Outcome