1.A Comparison between Home Based and Hospital-Based Pulmonary Rehabilitation Programmes Among COPD Patients in Improving Lung Functional Status
Ayiesah Ramli ; Roslina Abdul Manap ; Leonard Joseph
Malaysian Journal of Health Sciences 2008;6(1):95-108
This study was aimed at identifying the effectiveness of hospital-based pulmonary rehabilitation programme as compared to home-based pulmonary programme in improving the condition of the chronic obstructive pulmonary
disease (COPD) patients of Universiti Kebangsaan Malaysia Hospital. A total of 35 patients aging between 17 to 78 years old were randomised either to hospital (48.6%, n = 20) or home (43%, n = 15) -based pulmonary
rehabilitation by the Physiotherapists. For the hospital-based rehabilitation programme, the patients were scheduled to come to the hospital twice a week
for eight weeks. For home-based rehabilitation programme, subjects were scheduled to come to the Physiotherapy Department twice to learn on the exercises that need to be carried out before they are allowed to do on their own
at home. Each subject was given a diary to record the exercises that have been done. A telephone call is made once a week for monitoring purpose. Assessment
of lung function, six-minute-walk test and Borg score were carried out before and after the eight-week rehabilitation is conducted. The Results showed that there was no significant change in lung function for both groups before and after rehabilitation. There is a significant different (p < 0.05) in 6MWT before and after rehabilitation for hospital-based pulmonary rehabilitation patients.
However, the difference is not significant (p > 0.05) for home-base pulmonary rehabilitation patients. The results also show that there exist no significant
correlation between lung function and 6MWT even though there is an increase in walking distance at baseline or the eighth week. In conclusion, hospitalbased
pulmonary rehabilitation is more effective than the home-based pulmonary rehabilitation in improving the exercise endurance which would helps in reduce dyspnoea among COPD patients.
2.Reliability and Validity of the Malay Version Chronic Respiratory Questionnaire for used among COPD Patients
Ayiesah Ramli ; Teh Zi Ying ; Khatijahbe Mohd Ali ; Roslina Abdul Manap
Malaysian Journal of Medicine and Health Sciences 2014;10(2):83-93
Introduction: Chronic Respiratory Questionnaire (CRQ) is one of the disease-specific questionnaires
to assess health related quality of life (HRQoL) among chronic obstructive pulmonary disease (COPD)
patients. Objectives: This study investigate the validity and reliability of Malay version CRQ among
COPD patients. Methods: The CRQ was administered twice to 46 patients with COPD (mean FEV1
44% predicted, FEV1/ IVC 37% predicted) from Medical Center of University Kebangsaan Malaysia
(PPUKM).Test-retest reliability was assessed using intra-class correlation coefficients (ICC). Internal
consistency was determined using Crohnbach’s alpha coefficients (α = 0.7). Spearman’s correlation
coefficient was done among the scores of CRQ, St George Respiratory Questionnaire (SGRQ) and sixminute
walking test (6MWT) to examine the concurrent validity of the CRQ (p<0.05). Results: High
internal consistency (α > 0.70) was observed for 3 domains of CRQ with exception of dyspnoea domain
(α = -0.631). Test retest reliability demonstrated strong correlation (ICC >0.80). Concurrent validity
of CRQ, showed significant correlations observed between domain of SGRQ’s symptom, impact and
total scores of SGRQ with CRQ’s dyspnoea and emotional function (-0.3< r < -0.4; p<0.05). Significant
correlation was observed between 6MWT and CRQ’s fatigue domain (r= 0.390; p=0.007). Conclusions:
The Malay version of CRQ is a reliable instrument for measuring health status of patients among chronic
respiratory disease especially COPD. Items of fatigue, emotion, and mastery domain of the CRQ are
reliable and valid and can be used to assess quality of life in patients with severe airways obstruction.
Items of the dyspnoea dimension are less reliable and should not be included in the overall score of the
CRQ in comparative research.
Chronic Obstructive Pulmonary Disease