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Older persons can be susceptible to respiratory-related conditions, particularly pneumonia. This study examined the effects of breathing training on respiratory function, swallowing function, and quality of life in community-dwelling frail older persons with musculoskeletal disorders. The participants were divided into 2 groups. One group performed a regular rehabilitation programme, and the other group performed breathing training exercises, including a coughing exercise, respiratory muscle stretching exercise, and respiratory muscle training using a hand-held resistance device. The exercises improved respiratory function, swallowing, and quality of life. Such breathing training might be effective in helping to prevent pneumonia in frail older patients with musculoskeletal disorders. Objective: To investigate the effects of respiratory rehabilitation on respiratory function, swallowing in community-dwelling frail older patients with musculoskeletal disorders. Design: Randomized open-label controlled trial. Setting: Day-care facility in a rehabilitation hospital in Japan. Subjects: A total of 63 participants with musculoskeletal disorders (intervention group: n = 31; control group: n = 32) completed the randomized controlled trial. Interventions: All participants received 12 20-min sessions twice a week for 6 weeks of either typical rehabilitation (control) or typical rehabilitation with respiratory rehabilitation (intervention). Main measures: Outcome measures were assessed prior to rehabilitation and after 12 sessions. The measures included: respiratory function, swallowing function, exercise tolerance, 6-min walk distance, thorax flexibility, muscle strength (grip and abdominal), activities of daily living, and quality of life. Results: Participants in the intervention group showed significantly greater improvement in respiratory function (95% confidence interval (CI), 3.8-6.6; p = 0.01), swallowing function (95% CI-1.8-0.6; p = 0.01), and quality of life (SF8 Physical Summary Score) (95% CI 2.4-7.1; p = 0.01) compared with those in the control group. Conclusion: Addition of respiratory rehabilitation to a typical rehabilitation programme could improve not only respiratory and swallowing function, but also quality of life, in frail older patients.

Pulmonary function declined with pulmonary resection. After the patient recovered from the operation, pulmonary function decreased with time regardless of the surgical procedure.

Background: It is unclear whether postoperative follow-up by thoracic surgeons or chest physicians for non-small cell lung cancer (NSCLC) alters survival. Patients and Methods: The charts of 1,398 NSCLC patients, diagnosed between 1980 and 2008, were reviewed. Prognostic factors contained therein were evaluated using univariate and multivariate analyses. Patients were divided into 2 groups according to the doctor in charge of their postoperative follow-up: the thoracic surgeon group and the chest physician group. The doctors in charge of following up the patients were also analyzed for prognostic significance. Results: In the univariate and multivariate analyses, age 65 years or younger, female sex, early pathological stage, Charlson Index score of 0–1, absence of adjuvant therapy, and follow-up by a chest physician were significantly favorable prognostic factors. Exam-ined overall, NSCLC patients in the chest physician group had longer survival than those in the thoracic surgeon group. The difference in survival of patients with advanced disease was also statistically significant between these 2 groups. Conclusions: Our results indicate that early detection of asymptomatic disease by regular follow-up including chest computed tomography scan may improve the chance of treatment with curative intent and thus may increase survival, irrespective of the doctor in charge of follow-up.

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