La réadaptation respiratoire de patients atteints d'asthme bronchique et de broncho-pneumopathies obstructives chroniques (BPCO) à Kinshasa

A number of studies in western countries have shown that respiratory and physical rehabilitation of patients with chronic obstructive pulmonary disease (COPD) only has a minimal effect on respiratory function but can significantly improve physical capacity. The aim of our study was to apply these methods to patients in Kinshasa, Democratic Republic of Congo. We treated 38 patients (20 women) who had bronchial asthma (n = 14) or COPD (n = 24). These ambulatory patients were treated in two different hospitals in Kinshasa, the university hospital and the general hospital, three times per week for twelve weeks. The patients were treated with kinestherapy and inhaled bronchodilator drugs (salbutamol, and/or ipratropium bromide with a boreal nebulizer) as well as bronchial hygiene and performed breathing exercises on a Bodyguard Ergometer 990 with walking, running and climbing steps until exhaustion. After the rehabilitation program FEV1 increased from 1.37 ± 0.62 (50% expected) to 1.54 ± 0.69 (56% expected) (p < 0.01). The same trend was observed for walking distance (from 644 ± 459 m to 1213 ± 569 m, p < 0.001) and for maximal power developed on the cycloergometer (from 45 ± 20 w to 73 ± 37 w, p < 0.001). In contrast, the maximal work load performed during climbing steps (from 106 ± 44 w to 115 ± 23 w) did not improve significantly. COPD patients improved their FEV1 significantly compared with asthma patients. Our study show that pulmonary rehabilitation increase the level of spontaneous physical activity. The pulmonary rehabilitation program changes the quality of life of COPD patients who are able to move about better for longer periods of time, have a longer walking distance, and improved physical activity level.