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탄광부 진폐증 환자에서 맞춤형 호흡 재활 치료 프로그램의 임상적 효용성
정희 ( Hee Cheong ),이정민 ( Jeong Min Lee ),박인기 ( In Ki park ),김종규 ( Jong Kyu Kim ),전근재 ( Geun Jae Jeon ),김주령 ( Ju Ryung Kim ),김지홍 ( Ji Hong Kim ),최병용 ( Byoong Yong Choi ) 대한내과학회 2014 대한내과학회지 Vol.87 No.6
Background/Aims: It is unknown whether pulmonary rehabilitation (PR) is an effective intervention to manage coal worker pneumoconiosis (CWP). We evaluated the efficacy and safety of an individualized PR program in 53 patients with CWP hospitalized in two medical institutions. Methods: The PR program consisted of upper and lower extremity exercises to improve exercise endurance and skeletal musculoskeletal strength. All subjects performed treadmill and ergometer exercise with steady loading weights three times/week for 12 weeks. The following tests were performed before and after the study to investigate the efficacy of the PR program: modified Borg scale, pulmonary function test, mid-thigh circumference, maximum muscular strength, 6-min walk distance (6MWD), and the St. George’s Respiratory Questionnaire (SGRQ), Korean version. Results: Forty patients (75.5%) completed their PR programs. They improved significantly on the modified Borg scale, mid thigh circumference, maximum muscular strength, 6MWD (all p < 0.000), and SGRQ (p = 0.007), however, no significant improvement was observed on the pulmonary function test. A significant improvement in dyspnea (p = 0.004) and 6MWD (p = 0.002) was observed in 12 patients with forced expiratory volume in 1 sec < 60%. The PR program with smoking cessation resulted in significantly more improvement on the 6MWD (p < 0.0001) and the SGRQ score (p = 0.002), as compared to those of patients who did not quit smoking. Conclusions: Our results show that an individualized 12-week PR program improves exercise capacity and quality of life for patients with CWP. (Korean J Med 2014,87:690-697)