個別化物理治療計劃改善呼吸器依賴患者之生活功能及品質(病例報告)

Translated title of the contribution: Effects of Individualized Physical Therapy Intervention on Quality of Life and Functional Level of Ventilator-Dependent Patients

Ling-Ling Chiang, Li Ying Wang, Chin Pyng Wu, Ying Tai Wu

Research output: Contribution to journalArticle

Abstract

Background and purpose: Physical therapy intervention is an integral part in the management of ventilator-dependent patients to prevent further complications related to deconditioning. However, there were few studies focused on this field in Taiwan. This case report described physical therapy interventions and their effects for two ventilator-dependent patients. Case description: Two ventilator-dependent patients, one with amyotrophic lateral sclerosis (ALS) (case 1) and the other with chronic obstructive pulmonary disease (COPD) (case 2), were recruited from the respiratory care ward of a teaching hospital. Both cases received a 6-week individualized physical therapy intervention, which included airway clearance techniques, low-intensity peripheral muscle exercise, as well as transfer and ambulation training (exercise intensity was dyspnea to Borg scale 4-5). Results: Both cases showed improvement in bronchial hygiene. In case 1, the collapsed left lower lobe was re-opened with decreased sputum amount and needs for sputum suctioning. For case 2, although sputum amount was not changed but decreased needs for sputum suctioning and increased cough efficiency were noticed. Pulmonary function was not changed after intervention for both cases, but case 2 could tolerate without ventilator in the daytime. The two-minute walking distance (2MWD) of both cases increased, from “can’t measure” to 52.5 m and to 82.5 m in case 1 and 2, respectively. Functional level and quality of life were improved in both cases after intervention. For case 1, scores increased form 35 to 55 for Barthel Index (BI), 23 to 32 for motor domain of functional Independent measure (FIM), 16 to 21for physical domain of short-form 36 (SF-36), and 32 to 37 for mental domain of SF-36. as for case 2, scores increased from 55 to 80 for BI, 29 to 65 for motor domain of FIM, physical domain of SF-36 remained unchanged as 14, and mental domain of SF-36 increased from 41 to 45. Conclusion: Physical therapy intervention could improve bronchial hygiene, 2MWD, functional level and quality of life in ventilator-dependent patients and might help these patient to wean off the ventilator. In this patient group, individualized training programs that include chest physical therapy and task-oriented activity training should be emphasized.
Original languageTraditional Chinese
Pages (from-to)21-33
Number of pages13
Journal重症醫學雜誌
Volume6
Issue number1
Publication statusPublished - 2004

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Mechanical Ventilators
Quality of Life
Sputum
Hygiene
Walking
Therapeutics
Exercise
Taiwan
Cough
Teaching Hospitals
Dyspnea
Chronic Obstructive Pulmonary Disease
Teaching
Thorax
Efficiency
Education
Muscles
Lung

Keywords

  • 物理治療
  • 呼吸器依賴病患
  • 肌肉萎縮性脊髓側索硬化
  • 慢性阻塞型肺部疾病
  • Physical therapy
  • Ventilator-dependent patient
  • Amyotrophic lateral sclerosis
  • Chronic obstructive pulmonary disease

Cite this

個別化物理治療計劃改善呼吸器依賴患者之生活功能及品質(病例報告). / Chiang, Ling-Ling; Wang, Li Ying; Wu, Chin Pyng; Wu, Ying Tai.

In: 重症醫學雜誌, Vol. 6, No. 1, 2004, p. 21-33.

Research output: Contribution to journalArticle

Chiang, Ling-Ling ; Wang, Li Ying ; Wu, Chin Pyng ; Wu, Ying Tai. / 個別化物理治療計劃改善呼吸器依賴患者之生活功能及品質(病例報告). In: 重症醫學雜誌. 2004 ; Vol. 6, No. 1. pp. 21-33.
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title = "個別化物理治療計劃改善呼吸器依賴患者之生活功能及品質(病例報告)",
abstract = "研究背景與目的:物理治療應參與呼吸器依賴患者之長期照護,以進行持續呼吸器脫離和復健,而國內物理治療介入長期呼吸器病患的研究很少。本病例報告描述兩型呼吸器依賴者的物理治療過程及成效。 方法:從一醫學中心之呼吸照護病房最常見的兩類呼吸器依賴疾患中各選一位,分別是一肌肉萎縮性脊髓側索硬化病患(案例一)和一慢性阻塞型肺部疾病患者(案例二),進行6週個別化物理治療,包括痰液清除、低量之四肢肌肉耐力及行走訓練(強度為呼吸困難至柏格指數4-5分)。 結果:案例一塌陷之左下葉已再度擴張,痰量及抽痰頻率減少,而案例二之痰量雖未減少,但抽痰頻率減少且咳痰效率增加。兩名案例雖自呼肺功能未進步,但案例二病患能脫離至白天不用呼吸器。兩位整二分鐘行走距離皆有進步,由無法測試增加血52.5米(案例一)及82.5米(案例二)。生活功能及部分生活品質也都有所改善。案例一之巴氏量表分數由35增至55分、功能獨主自主量表之動作領域由23增至32分、SF-36量表之身體範疇由16增至21分、心智範疇由32增至37分。案例二之巴氏量表分數由55增至80分,功能獨立自主量表之動作領域由29增至65分、SF-36量表之身體範疇維持14分,心智範疇則由41增至45分。 結論:物理治療的積極介入,可以改善仰賴呼吸器之神經肌肉疾患和慢性阻塞型肺部疾患的咳痰功能、二分鐘行走距離、生活功能和生活品質,甚至有助於協助該慢性阻塞型肺部疾病患者呼吸器之脫離。兩種患者皆需強調個別化的胸腔物理治療,及功能取向之生活功能訓練。",
keywords = "物理治療, 呼吸器依賴病患, 肌肉萎縮性脊髓側索硬化, 慢性阻塞型肺部疾病, Physical therapy, Ventilator-dependent patient , Amyotrophic lateral sclerosis, Chronic obstructive pulmonary disease",
author = "Ling-Ling Chiang and Wang, {Li Ying} and Wu, {Chin Pyng} and Wu, {Ying Tai}",
year = "2004",
language = "繁體中文",
volume = "6",
pages = "21--33",
journal = "重症醫學雜誌",
issn = "1563-356x",
publisher = "中華民國重症醫學會",
number = "1",

}

TY - JOUR

T1 - 個別化物理治療計劃改善呼吸器依賴患者之生活功能及品質(病例報告)

AU - Chiang, Ling-Ling

AU - Wang, Li Ying

AU - Wu, Chin Pyng

AU - Wu, Ying Tai

PY - 2004

Y1 - 2004

N2 - 研究背景與目的:物理治療應參與呼吸器依賴患者之長期照護,以進行持續呼吸器脫離和復健,而國內物理治療介入長期呼吸器病患的研究很少。本病例報告描述兩型呼吸器依賴者的物理治療過程及成效。 方法:從一醫學中心之呼吸照護病房最常見的兩類呼吸器依賴疾患中各選一位,分別是一肌肉萎縮性脊髓側索硬化病患(案例一)和一慢性阻塞型肺部疾病患者(案例二),進行6週個別化物理治療,包括痰液清除、低量之四肢肌肉耐力及行走訓練(強度為呼吸困難至柏格指數4-5分)。 結果:案例一塌陷之左下葉已再度擴張,痰量及抽痰頻率減少,而案例二之痰量雖未減少,但抽痰頻率減少且咳痰效率增加。兩名案例雖自呼肺功能未進步,但案例二病患能脫離至白天不用呼吸器。兩位整二分鐘行走距離皆有進步,由無法測試增加血52.5米(案例一)及82.5米(案例二)。生活功能及部分生活品質也都有所改善。案例一之巴氏量表分數由35增至55分、功能獨主自主量表之動作領域由23增至32分、SF-36量表之身體範疇由16增至21分、心智範疇由32增至37分。案例二之巴氏量表分數由55增至80分,功能獨立自主量表之動作領域由29增至65分、SF-36量表之身體範疇維持14分,心智範疇則由41增至45分。 結論:物理治療的積極介入,可以改善仰賴呼吸器之神經肌肉疾患和慢性阻塞型肺部疾患的咳痰功能、二分鐘行走距離、生活功能和生活品質,甚至有助於協助該慢性阻塞型肺部疾病患者呼吸器之脫離。兩種患者皆需強調個別化的胸腔物理治療,及功能取向之生活功能訓練。

AB - 研究背景與目的:物理治療應參與呼吸器依賴患者之長期照護,以進行持續呼吸器脫離和復健,而國內物理治療介入長期呼吸器病患的研究很少。本病例報告描述兩型呼吸器依賴者的物理治療過程及成效。 方法:從一醫學中心之呼吸照護病房最常見的兩類呼吸器依賴疾患中各選一位,分別是一肌肉萎縮性脊髓側索硬化病患(案例一)和一慢性阻塞型肺部疾病患者(案例二),進行6週個別化物理治療,包括痰液清除、低量之四肢肌肉耐力及行走訓練(強度為呼吸困難至柏格指數4-5分)。 結果:案例一塌陷之左下葉已再度擴張,痰量及抽痰頻率減少,而案例二之痰量雖未減少,但抽痰頻率減少且咳痰效率增加。兩名案例雖自呼肺功能未進步,但案例二病患能脫離至白天不用呼吸器。兩位整二分鐘行走距離皆有進步,由無法測試增加血52.5米(案例一)及82.5米(案例二)。生活功能及部分生活品質也都有所改善。案例一之巴氏量表分數由35增至55分、功能獨主自主量表之動作領域由23增至32分、SF-36量表之身體範疇由16增至21分、心智範疇由32增至37分。案例二之巴氏量表分數由55增至80分,功能獨立自主量表之動作領域由29增至65分、SF-36量表之身體範疇維持14分,心智範疇則由41增至45分。 結論:物理治療的積極介入,可以改善仰賴呼吸器之神經肌肉疾患和慢性阻塞型肺部疾患的咳痰功能、二分鐘行走距離、生活功能和生活品質,甚至有助於協助該慢性阻塞型肺部疾病患者呼吸器之脫離。兩種患者皆需強調個別化的胸腔物理治療,及功能取向之生活功能訓練。

KW - 物理治療

KW - 呼吸器依賴病患

KW - 肌肉萎縮性脊髓側索硬化

KW - 慢性阻塞型肺部疾病

KW - Physical therapy

KW - Ventilator-dependent patient

KW - Amyotrophic lateral sclerosis

KW - Chronic obstructive pulmonary disease

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UR - http://readopac1.ncl.edu.tw/nclJournal/search/summny_list.jsp?sysId=0004807903&dtdId=000040

M3 - 文章

VL - 6

SP - 21

EP - 33

JO - 重症醫學雜誌

JF - 重症醫學雜誌

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