Functional Evaluation for Planning Exercise Programs in Patients with Chronic Diseases

Abstract

Chronic diseases such as chronic obstructive pulmonary disease (COPD), chronic kidney disease, stroke, chronic pain, usually lead to impaired muscle strength and endurance, and affect movement functions. Therefore it is a role of physiatrists to perform functional evaluation so that appro-priate rehabilitation programs could be planned.

In this issue, there are seven interesting original articles. Two studies used a 6-minute walk test (6MWT) and a 6-minute walk distance (6MWD) to evaluate cardiac and pulmonary functions: one used it to detect cardiac arrhythmia, an indicator to terminate phase II cardiac rehabilitation program and the other used it to detect risk of COPD exacerbation. The 6MWT is a practical evaluation that physiatrists could perform to evaluate patients’ functions or fitness.

To restore muscle and movement functions, one needs exercise. High resistance and low repetition for strengthening muscle whereas low resistance and high repetition for improving muscle endurance. Weights and exercise equipment are commonly used for exercise trainings. However, these equipment may not be available and suitable for elderly. In this issue, one study introduced using a simple Thai-style braided rubber rope for a home-based exercise. It showed some improvement in muscle strength and quality
of life of patients on continuous ambulatory peritoneal dialysis. However, patient’s adherence to exercise is one of key success factors.

Another study in this issue is about poststroke depression which is prevalent during the first two years after stroke. Depression, if not well treated, affects motivation. Being a physiatrist, one should be aware of depression as it is a barrier to achieve optimal rehabilitation outcomes. Therefore one should be able to early detect depression which is rather common among those with chronic diseases seen in medical rehabilitation practice.