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Tri-state region pulmonary rehabilitation survey. Delivery of exercise conditioning services. The Pulmonary Rehabilitation Committee, Tri-State Society for Cardiovascular and Pulmonary Rehabilitation.

PURPOSE
This report analyzes the delivery of exercise conditioning services in the 1991 Pennsylvania, New Jersey, and Delaware regional survey of pulmonary rehabilitation programs.


METHODS
Data from a questionnaire was analyzed with special consideration given to whether the program provided services for patients with only pulmonary diseases (n = 41) or with cardiac and pulmonary diseases (n = 18).


RESULTS
All 59 programs included exercise conditioning. Most programs (67%) used oxygen saturation and/or expired gas analysis for writing exercise prescriptions. Only pulmonary programs used 6- or 12-minute walk data. The exercise prescription was written by nonphysicians in 51% of the programs. Most pulmonary-only programs used respiratory therapists by themselves or in combination with other professionals as exercise supervisors (71%). Cardiopulmonary programs used exercise physiologists by themselves (22%) or nurses by themselves or in combination with other professionals (50%). For all programs, the standard for ratio of patients to exercise staff averaged 3.0:1. Pulmonary-only programs did slightly but significantly more continuous arterial oxygen percent saturation (SaO2) monitoring rather than spot checking. A standard determining the use of supplemental oxygen during exercise was reported by 78% of all programs. Most used supplemental oxygen after observing the SaO2 level falling to < 90%. Electrocardiograph monitoring was done in 66% of pulmonary-only programs, but in 94% of the cardiopulmonary programs. Maintenance sessions were offered by 64% of the pulmonary-only programs and also by 78% of the cardiopulmonary programs.


CONCLUSION
The type of rehabilitation program, either pulmonary-only or cardiopulmonary, appears to influence the exercise conditioning services used by the pulmonary patient.