THE REHABILITATION OF CHRONIC RESPIRATORY INSUFFICIENCY

Respiratory rehabilitation is defined as a medical practice including a multidisciplinary medical program fitting each individual. Personali sed retraining, by means of exercises, is the master part of it, its a im is to improve the physical fitness in specialised institution then to maintain it when he becomes an out patient, In both cases, this ret raining complies with strict rules concerning the mode of these exerci ses (imposed power - duration of sessions - weekling frequency - progr essiveness of overloading...). This codification rests mainly on the r ecommendations of the American College of Sports Medicine. The choice of intensity at the begining of the stay will be determined either by the maximal reserve of cardiac frequency or by the ventilatory thresho ld. This training has to involve extensive muscular mass and must not neglect the upper limbs. Ventilatory physiotherapy also plays an impor tant part. The other components of rehabilitation concern optimisation of bronchodilator treatment, cessation of smoking, health education, physical education and relaxation, appraisal of nutritional status, as sessment of therapeutic programs, of the quality of life and a long-te rm program for reinforcement of acquisitions. The therapeutic programs improve ventilatory performance, maximal oxygen intake, maximal toler ated power and quality of life. An adaptation of the St George's Respi ratory Questionnaire to patients hosted at the TOKI EDER Medical Cente r points out that the quality of life of patients with chronic respira tory failure is improved very highly significantly by this rehabilitat ion.