Effect of respiratory rehabilitation for frail older patients with musculoskeletal disorders: a randomized controlled trial

Older persons can be susceptible to respiratory-related conditions, particularly pneumonia.This study examined the effects of breathing training on respiratory function, swallowing function, and quality of life in community-dwelling frail older persons with musculoskeletal disorders.The participants were divided into 2 groups.One group performed a regular rehabilitation programme, and the other group performed breathing training exercises, including a coughing exercise, respiratory muscle stretching exercise, and respiratory muscle training using a hand-held resistance device.The exercises improved respiratory function, swallowing, and quality of life.Such breathing training might be effective in helping to prevent pneumonia in frail older patients with musculoskeletal disorders. 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), 3.8-6.6;p = 0.01), swallowing function (95% CI -1.8-0.6;p = 0.01), and quality of life (SF8 Physical Summary Score) (95% CI 2.4-7.1;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.