title: The effects of 'on-call/out of hours' physical therapy in acute exacerbations of chronic obstructive pulmonary disease: a randomized controlled trial.
abstract: OBJECTIVE
  To assess the effectiveness of an on-call physical therapy programme in the management of acute exacerbations of chronic obstructive pulmonary diseases.
  
  
  METHODS
  Randomized controlled trial.
  
  
  METHODS
  Secondary care level, rural hospital.
  
  
  METHODS
  Thirty-eight patients with acute exacerbations of chronic obstructive pulmonary disease.
  
  
  METHODS
  Regular physical therapy and on-call physical therapy was given to two groups of patients with 19 in each arm. On-call physical therapy included providing respiratory physical therapy as required by the patient out of business hours.
  
  
  METHODS
  Peak expiratory flow rate, sustained maximal inspiration, six-minute walk distance and rating of perceived exertion post six-minute walk test.
  
  
  RESULTS
  In the group receiving on-call physical therapy, peak expiratory flow rate and six-minute walk test showed a significant difference (52.1 L/min and 98.16 m, respectively) when compared with the control group (211.57 +/- 51.12 L/min and 159.47 +/- 67.78 L/min; P =0.01 and 387.89 +/- 110.1 m and 289.73 +/- 103.2 m; P=0.004 respectively). The difference in peak expiratory flow rate (Delta peak expiratory flow rate) was seen to be more in the on-call group (120 L/min) when compared to the control group (50 L/min), P =0.002. Improvements in sustained maximal inspiration and Borg's rating of perceived exertion after the six-minute walk test were also observed (P>0.05).
  
  
  CONCLUSIONS
  On-call physical therapy brings about a significant increase in peak expiratory flow rates, six-minute walk distance and sustained maximal inspiration.
authors.affiliation: Department of Rehabilitation, CSI Mission Hospital, Tirur, Kerala, India. abrahambabu@gmail.com
authors.forename: Abraham Samuel
authors.initials: AS
authors.lastname: Babu
authors.forename: Manjula Sukumari
authors.initials: MS
authors.lastname: Noone
authors.forename: Mohammed
authors.initials: M
authors.lastname: Haneef
authors.forename: Prasanna
authors.initials: P
authors.lastname: Samuel
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D001945:Breathing Exercises; D018450:Disease Progression; D005080:Exercise Test; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D012129:Respiratory Function Tests; D016138:Walking