Effect evaluation and qualitative research analysis of self-management device for pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

doi:10.3877/cma.j.issn.2095-8757.2025.03.004

Abstract

Abstract:

Objective

To investigate the clinical efficacy of a pulmonary rehabilitation self-management device in improving lung function in patients with stable chronic obstructive pulmonary disease (COPD).

Methods

A total of 90 stable COPD patients who met the inclusion and exclusion criteria and received basic pharmacological treatment were enrolled from the First Hospital of Shanxi Medical University between June 2024 and February 2025. They were randomly divided into three groups using a random number table: the self-management group (remote supervision and daily rehabilitation training using the pulmonary rehabilitation self-management device), the home rehabilitation group (daily home-based rehabilitation training with record-keeping and monthly telephone follow-ups), and the health education group (receiving pulmonary rehabilitation education at discharge). Each group consisted of 30 patients. After 12 weeks, lung function, exercise endurance, muscle strength, and dyspnea improvement were compared among the three groups. T test, non-parametric test, or analysis of variance was used to compared the measurement data, χ² test was used to compared the count data.

Results

A total of 28 patients in the home rehabilitation group, 29 in the self-management group, and 30 in the health education group completed the training and follow-up. Baseline characteristics showed no statistically significant differences among the three groups (P > 0.05). There was no statistically significant difference in the forced expiratory volume in one second (FEV1), forced vital capacity (FVC), the percentage of predicted FEV1 (FEV1%pred), and FEV1/FVC before and after treatment among the three groups (P > 0.05). In the self-management group, FEV1, FVC, FEV1%pred, and FEV1/FVC were significantly improved after treatment compared with those before treatment (t=-10.030, -4.647; Z=-9.604, -4.622; P < 0.01). After treatment, there were statistically significant differences in the 6-minute walk distance (6MWD), grip strength, 5-repetition sit-to-stand test (5R-STST), and COPD assessment test (CAT) scores among the three groups (F=5.015, 8.860; H=10.477, 12.795; P < 0.01). Among them, the self-management group showed the most significant improvement in all indicators (P < 0.05). After treatment, the 6MWD, grip strength, CAT score, and 5R-STST scores in both the home-based rehabilitation group and the self-management group showed significant improvement compared to those before treatment (t=-3.247, -2.066, Z=3.198, -4.690; t=-4.703, -14.832, Z=-4.406, 2.436; P < 0.01). The training compliance score in the self-management group was significantly higher than that in the home-based rehabilitation group (t=-3.300, P < 0.01).

Conclusion

The use of a pulmonary rehabilitation self-management device for daily training management in COPD patients effectively enhances training compliance, thereby significantly improving lung function, limb muscle strength, exercise endurance, and dyspnea symptoms.

Key words: Pulmonary rehabilitation, Self management device, Chronic obstructive, Pulmonary disease, Compliance

Li Kang, Junzhi Li, Xue Wu, Yufeng Du. Effect evaluation and qualitative research analysis of self-management device for pulmonary rehabilitation in patients with chronic obstructive pulmonary disease[J]. Chinese Journal of Geriatrics Research(Electronic Edition), 2025, 12(03): 25-30.

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References 21

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组别	例数	男性[例（%）]	年龄[M（P₂₅，P₇₅），岁]	BMI（±s，kg/m²）	GOLD分级（1级/2级/3级/4级，例）	吸烟指数[M（P₂₅，P₇₅）]
家庭康复组	28	23（82.14）	68.50（61.50，72.75）	22.39±3.54	3/19/4/2	550（325，800）
自我管理组	29	21（72.41）	64.00（67.00，69.50）	23.38±3.43	5/19/4/1	600（0，1000）
健康宣教组	30	25（83.33）	62.50（58.75，68.25）	22.22±3.49	2/24/3/1	700（450，1200）
检验值		χ²=1.273	H=4.768	F=0.935	χ²=2.277	H=2.682
P值		>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	男性[例（%）]	年龄[M（P₂₅，P₇₅），岁]	BMI（±s，kg/m²）	GOLD分级（1级/2级/3级/4级，例）	吸烟指数[M（P₂₅，P₇₅）]
家庭康复组	28	23（82.14）	68.50（61.50，72.75）	22.39±3.54	3/19/4/2	550（325，800）
自我管理组	29	21（72.41）	64.00（67.00，69.50）	23.38±3.43	5/19/4/1	600（0，1000）
健康宣教组	30	25（83.33）	62.50（58.75，68.25）	22.22±3.49	2/24/3/1	700（450，1200）
检验值		χ²=1.273	H=4.768	F=0.935	χ²=2.277	H=2.682
P值		>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	FEV1				FVC
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
家庭康复组	28	1.16±0.39	1.18±0.39	-2.250	<0.05	2.13±0.52	2.15±0.53	-2.238	<0.05
自我管理组	29	1.23±0.22	1.32±0.21	-10.030	<0.01	1.98±0.29	2.11±0.28	-4.647	<0.01
健康宣教组	30	1.21±0.24	1.20±0.26	-1.909	>0.05	2.14±0.35	2.13±0.34	-0.165	>0.05
检验值		F=1.925	F=5.408			F=3.723	F=0.051
P值		>0.05	>0.05			>0.05	>0.05
组别	例数	FEV1%pred				FEV1/FVC
组别	例数	治疗前	治疗后	Z值	P值	治疗前	治疗后	Z值	P值
家庭康复组	28	65.77（61.95，70.37）	65.90（61.90，70.46）	-2.554	<0.05	61.26（58.06，62.64）	61.46（58.12，62.67）	-1.899	>0.05
自我管理组	29	66.93（63.98，79.52）	67.03（64.19，79.74）	-9.604	<0.01	62.69（60.42，64.30）	62.86（61.20，64.31）	-4.622	<0.01
健康宣教组	30	64.70（54.79，69.92）	64.68（54.34，69.45）	-1.925	>0.05	59.55（49.73，64.24）	60.28（49.54，64.23）	-0.010	>0.05
检验值		H=3.791	H=4.567			H=5.687	H=5.717
P值		>0.05	>0.05			>0.05	>0.05

组别	例数	FEV1				FVC
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值
家庭康复组	28	1.16±0.39	1.18±0.39	-2.250	<0.05	2.13±0.52	2.15±0.53	-2.238	<0.05
自我管理组	29	1.23±0.22	1.32±0.21	-10.030	<0.01	1.98±0.29	2.11±0.28	-4.647	<0.01
健康宣教组	30	1.21±0.24	1.20±0.26	-1.909	>0.05	2.14±0.35	2.13±0.34	-0.165	>0.05
检验值		F=1.925	F=5.408			F=3.723	F=0.051
P值		>0.05	>0.05			>0.05	>0.05
组别	例数	FEV1%pred				FEV1/FVC
组别	例数	治疗前	治疗后	Z值	P值	治疗前	治疗后	Z值	P值
家庭康复组	28	65.77（61.95，70.37）	65.90（61.90，70.46）	-2.554	<0.05	61.26（58.06，62.64）	61.46（58.12，62.67）	-1.899	>0.05
自我管理组	29	66.93（63.98，79.52）	67.03（64.19，79.74）	-9.604	<0.01	62.69（60.42，64.30）	62.86（61.20，64.31）	-4.622	<0.01
健康宣教组	30	64.70（54.79，69.92）	64.68（54.34，69.45）	-1.925	>0.05	59.55（49.73，64.24）	60.28（49.54，64.23）	-0.010	>0.05
检验值		H=3.791	H=4.567			H=5.687	H=5.717
P值		>0.05	>0.05			>0.05	>0.05

组别	例数	6MWD				握力				5R-STST
组别	例数	治疗前	治疗后	t值	P值	治疗前	治疗后	t值	P值	治疗前	治疗后	Z值	P值
家庭康复组	28	311.22±68.33	321.48±78.51	-3.247	<0.01	22.13±4.41	23.08±5.47	-2.066	<0.05	14.57（12.74，16.94）	14.14（12.16，16.53）	3.198	<0.01
自我管理组	29	327.51±70.02	368.31±69.20	-4.703	<0.01	22.57±4.03	26.19±4.49	-14.832	<0.01	14.16（13.64，16.15）	12.17（11.43，13.29）	23.436	<0.01
健康宣教组	30	308.09±71.65	313.42±66.55	-0.072	>0.05	21.40±4.09	21.09±4.00	-1.841	>0.05	13.97（12.59，16.14）	14.22（12.50，16.13)	-1.748	>0.05
检验值		F=0.646	F=5.015			F=0.596	F=8.860			H=0.480	H=10.477
P值		>0.05	<0.01			>0.05	<0.01			>0.05	<0.01

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