Respiratory therapy
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Respiratory therapy · Sep 1984
Ventilatory and nonventilatory muscle exercise in COPD rehabilitation.
For maximum benefit, a rehabilitation program for patients with chronic obstructive pulmonary disease (COPD) should include both ventilatory and nonventilatory muscle exercise. The 12-week, outpatient program at Malden (Mass) Hospital incorporates whole-body exercise (walking), inspiratory resistive loading, and use of supplemental oxygen. ⋯ A cardiopulmonary exercise test, 12-minute walk, and endurance test provide the before and after rehabilitation testing protocol. Such a program can be implemented at a community hospital where most patients with COPD have their greatest access to medical care.
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Computerization of pulmonary function testing is forcing rewrites of time-honored protocols and shifting responsibilities from technician to machine. Spirometry, in particular, has become a diagnostic test virtually free of manual measurements and calculations; computerization even provides interpretation of the results. Along with these improvements, computerized spirometry also raises questions regarding reference values, interpretive criteria, and standardization.
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Ideally, rehabilitation restores an ill or injured person to a condition of health and useful activity. Toward this goal, patient education shows persons how they can take control of their lives and participate in their own health care. In chronic obstructive pulmonary disease, a program consisting of only classes and demonstrations on breathing exercises, oxygen therapy, and physical reconditioning is not enough. The programs that have had the greatest success establish a support network that continues long after the workshops or classes have ended.
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The success of a respiratory therapy department depends on the performance of its personnel, and its managers are charged with ensuring that employees meet departmental expectations. One means to effect change is through a formal performance appraisal system.