Efecto del entrenamiento al ejercicio en cifoescoliosis.

OBJECTIVES: To analyse the effect of a respiratory rehabilitation programme on the control of the respiratory symptoms in patients with hypercapnic respiratory insufficiency (HRF) secondary to kyphoscoliosis. METHODS: We studied 15 patients, 8 men and 7 women, diagnosed with HRF secondary to kyphoscoliosis, under treatment with home mechanical ventilation (HMV) for at least 6 months and without complete control of the symptoms. We initiated an exercise training protocol, randomly creating two groups: control and training. The patients underwent a functional evaluation at the beginning and at the end of the study consisting of: forced spirometry, plethysmography, arterial gasometry, MIP and MEP, one repetition maximum strength test (1-RM test), maximum and sub-maximum effort tests on a cycloergometer, Shuttle Walking Test (SWT) and dyspnoea by MRC and BDI/TDI scales. The training group: were treated with HMV and a mixed exercise training programme. The control group received treatment with HMV. RESULTS: With HMV the hypoventilation symptoms improved significantly, without significant improvement of the dyspnoea symptom. After the training programme: the control group did not show significant changes in the measured parameters; the training group showed significant changes in the dyspnoea symptom: both basal (from Pre-RR = 4[0.75] to Post-RR = 3.50[1] according to the MRC scale, and Pre-RR = 2.33[2] to Post-RR = 4[2.33] according to the basal dyspnoea index of Mahler) and after effort (from Pre- RR = 9[1.75] to Post- RR = 7[5] according to the Borg scale after the endurance test). In addition, an improvement was observed in the effort capacity of those patients who underwent the exercise training programme. CONCLUSIONS: The respiratory rehabilitation (RR) associated to HMV, is able to improve the dyspnoea, effort capacity and therefore, the quality of life in patients with severe kyphoscoliosis in the HRF situation.