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REHABILITATION.

Reviews a research article on a hospital program. In-hospital, short-term training program for patients with chronic airway obstruction. Author's purpose to examine whether short-term rehabilitation program produces the same outcomes as long-term. Cost analysis comparison. Research design. Data analyses and findings.

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CRITICAL EVALUATION OF ARTICLE ON REHABILITATION
Rehabilitation consists of a treatment or treatments designed to facilitate the process of recovery from injury, illness, or disease in patients back to as normal a condition as possible. This paper reviews an article on a short-term rehabilitation program for patients with chronic air-way obstruction. The article is:
Clini, E. (November, 2001). In-hospital short-term training program for patients with chronic airway obstruction. Chest, 120, 1500-1505.
Section I
Research Problem/Purpose
Based on a brief but to-the-point review of the literature, Clini (2001) shows that the existing research on rehabilitation programs

However, no specifics are given other than to say that allpatients signed informed consent forms. Thiswill allow for an assessment of the short-term training that iscomprehensive in scope. Presentation of Data and Data Analysis A series of two way repeated measures analyses of variance and t-testcomparisons indicated that both groups showed about the same levels ofimprovement in exercise tolerance measures. Control subjects were exposed to 2 to 24sessions (3 sessions per week) of outpatient PRP. This paper reviews anarticle on a short-term rehabilitation program for patients with chronicair-way obstruction. Conclusions Based on the findings observed in the study, Clini concluded thatpatients with chronic airway obstruction can attain relatively the sameamount of improvement in a short-term but intense inpatient PRP than theywould in a longer-term, less intense outpatient program. (November, 2 1). This could be a potential confounding factor because the likelihood isincreased that case subjects are in better physical condition relative totheir illness than control subjects which, in turn, could account for anequivalence of exercise tolerance for the two groups. Costs ofeach program were also evaluated. However, Clinidoes note that exercise tolerance is not the only index of theeffectiveness of PRP. Based on thefindings of an earlier, preliminary comparative study, it was hypothesizedthat the intense but short-term rehabilitation program provided toinpatients would produce equivalent functional outcomes and be lower incost than a standard longer-term program given to outpatients. With respect to the conductedcost analysis, findings showed that while the outpatient group's singledaily session was cheaper than the session of the inpatient group, it wasfound that due to the more frequent sessions received over time, theoutpatient group costs were significantly higher. All subjects (both caseand control subjects) were measured at baseline and then again after theprogram was completed. Statistical analysis of the effectiveness of matching proceduresshowed strong similarities in both groups although it was found thatsignificantly more case subjects than control subjects were at their firstPRP. Chest, 12 , 15 -15 5. Given that costs increase with length of program, Clini's purposeis to examine whether a short-term training pulmonary rehabilitationprogram produces roughly the same outcomes as longer programs. Section II Critiquer's Recommendation for Applicability of Research FindingsIn general, this study indicated that it is highly likely that short-termintense PRP can be effectively used for inpatients, a change in proceduresthat could save hospital costs. The experimental group of inpatients were exposed to 1 -12 daily sessions (5 sessions per week) of inpatient pulmonaryrehabilitation training (PRP). He alsoconducts a cost analysis comparing short-term to long-term training. Clini (2 1) reports that stipulated guidelines werefollowed. Chest, 12 , 15 -15 5. Further, as suggested by Clini(2 1), those clinics undertaking replication should include physiologicand clinical indices as part of their overall measurement battery. Section I Research Problem/Purpose Based on a brief but to-the-point review of the literature, Clini(2 1) shows that the existing research on rehabilitation programs forpatients with chronic-air-way obstruction (CAO) does not definitively statehow long rehabilitation programs should be in order to produce desiredoutcomes. Thus,the rationale for the study is thoroughly articulated along with itspurpose and, in addition, is grounded in the existing knowledge base. In-hospital short-term training program forpatients with chronic airway obstruction. In-hospital short-term training program for patients with chronic airway obstruction. Ethics The rehabilitation clinic providing PRP, the Salvatore MaugeriFoundation, had an ethics committee which set up ethical guidelines for allclinic research. The study should be used as a foundationfor hospitals to motivate their pulmonary rehabilitation clinics toundertake replications of this research. Measurements were of exercise tolerance and includedan evaluation of dysnea and leg fatigue using standardized tests. (November, 2 1). CRITICAL EVALUATION OF ARTICLE ON REHABILITATION Rehabilitation consists of a treatment or treatments designed tofacilitate the process of recovery from injury, illness, or disease inpatients back to as normal a condition as possible. ReferenceClini, E. The article is:Clini, E. Design/Research Hypotheses This was a retrospective case-control study in which functionaloutcomes and program costs were compared for short-term inpatient versuslong-term outpatient pulmonary rehabilitation programs (PRP). Therefore, it is recommended that the study bereplicated using several additional physiologic and clinical outcomesmeasures. The factthat Clini (2 1) is building on earlier work which he is replicating andextending adds to the strength of the study and the study's hypothesis.Methodology/Procedures/Data Collection There were 43 case subjects examined in the study, all of whom werematched for age, sex and a diagnosis of either COPD or asthma to a set ofcontrol subjects.

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