Objective: The purpose of this study was to develop a respiratory rehabilitation protocol suitable for patients with lung injury caused by humidifier disinfectants and to evaluate its effectiveness.
Methods: From August 2018 to February 2020, we recruited patients with decreased pulmonary function and poor activity of daily living (at least 2 points in modified Medical Research Council (mMRC) scale) among patients with lung disease caused by exposure to humidifier disinfectants. The study was scheduled of examinations and questionnaire at the first visit(T0), home-based pulmonary rehabilitation during 8 weeks, compliance check by telephone after 4 weeks, and examinations and questionnaire at the second visit(T1) after 8 weeks.
The mMRC and COPD assessment test (CAT), which subjectively evaluates the degree of dyspnea, strength evaluation such as grip strength, quadriceps muscle strength and respiratory muscle strength, pulmonary function test (PFT), 6 minutes walking test (6MWT) and cardiopulmonary function test were used as assessment tools.
To evaluate the degree which respiratory diseases affects quality of life and the general health, Saint George's Respiratory Questionnaire (SGRQ) and 36-Item Short Form Survey version (SF-36) were used.
A program consisting of respiratory rehabilitation in hospital twice a week and daily self-rehabilitation exercise was conducted, and inpatient treatment was considered when outpatient treatment was difficult.
The respiratory rehabilitation protocol was implemented as follows : breathing retraining; inspiratory muscles training; upper and lower extremities relaxation and stretching; strengthening exercise of the abdominal muscles and the upper and lower extremities; aerobic exercise using treadmill, bicycle ergometer, or arm ergometer; upper and lower extremities stretching and relaxation for cool down.
Results: A total of 20 subjects were recruited, and 11 subjects completed the second evaluation. 6MWT, MEP, FVC and FEV1/FVC of PFT, CAT, physical functioning (PF) and physical component score (PCS) of SF-36 were improved in the second evaluation compared to the first evaluation.
Conclusions: The results showed the respiratory rehabilitation improves pulmonary function and physical health of patients with lung diseases caused by exposure to humidifier disinfectants. However, larger sample size is needed to investigate the effectiveness and efficacy of respiratory rehabilitation. |
