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Effect of respiratory rehabilitation for frail older patients with musculoskeletal disorders: a randomized controlled trial [with consumer summary]
Maki N, Sakamoto H, Takata Y, Kobayashi N, Kikuchi S, Goto Y, Ichimura H, Sato Y, Yanagi H
Journal of Rehabilitation Medicine 2018 Nov;50(10):908-913
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To investigate the effects of respiratory rehabilitation on respiratory function, swallowing in community-dwelling frail older patients with musculoskeletal disorders. DESIGN: Randomized open-label controlled trial. SETTING: Day-care facility in a rehabilitation hospital in Japan. SUBJECTS: A total of 63 participants with musculoskeletal disorders (intervention group n = 31; control group n = 32) completed the randomized controlled trial. INTERVENTIONS: All participants received 12 20-min sessions twice a week for 6 weeks of either typical rehabilitation (control) or typical rehabilitation with respiratory rehabilitation (intervention). MAIN MEASURES: Outcome measures were assessed prior to rehabilitation and after 12 sessions. The measures included: respiratory function, swallowing function, exercise tolerance, 6-min walk distance, thorax flexibility, muscle strength (grip and abdominal), activities of daily living, and quality of life. RESULTS: Participants in the intervention group showed significantly greater improvement in respiratory function (95% confidence interval (CI) 3.8 to 6.6; p = 0.01), swallowing function (95% CI -1.8 to 0.6; p = 0.01), and quality of life (SF8 Physical Summary Score) (95% CI 2.4 to 7.1; p = 0.01) compared with those in the control group. CONCLUSION: Addition of respiratory rehabilitation to a typical rehabilitation programme could improve not only respiratory and swallowing function, but also quality of life, in frail older patients.

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