[Elements to be taken into consideration in the establishment and supervision of respiratory rehabilitation programs]

For a good respiratory re-education, the handicap must be analyzed together with its causes and mechanisms, in relation with the patient's social environment, his age and profession. The handicapping factors should be analyzed in a medico-social (pollution, weather) and medical context by detecting the affection involved and the functional analysis. The latter is deduced from the clinical signs and measurements defining the functional syndrome justifying an appropriate treatment. The importance of the handicap is drawn out of the clinical measures of maximum effort studied by ergometry. There are 2 levels of handicap (without alteration of blood gases at rest) and of respiratory insufficiency: simple or complicated by decompensation bouts enabling the choice of re-adapatation methods correlated with age an environment. Clinical and functional supervision as well as the study of the integration in the environment, form the basis of the analysis of results obtained in 2 comparable groups or in one homogeneous group subjected first to a simple medical treatment, then to re-adaptation.