Obesity is one of the most important public health problems, and it is increasing in prevalence worldwide (1,2). Obesity is an inflammatory disease that involves many systems in the body, especially the respiratory system, causing changes in pulmonary functions (2). Chronic obstructive pulmonary disease (COPD) is also an important public health problem usually accompanied by nutritional abnormalities (3, 4). The majority of COPD patients are overweight or obese rather than normal or low-weight (4). Obesity and COPD cause mortality and morbidity all over the world, and this global outbreak is predicted to be much higher in the future (5). Obesity might be the reason for respiratory symptoms alone due to decreased pulmonary compliance, increased work in breathing, and increased need for oxygen, even without airway obstruction. However, obesity might also increase the numbers of obstructed peripheral airways (6). It was determined that dyspnea perception is enhanced, health status is impaired, and quality of life (QOL) is reduced in obese COPD patients compared to non-obese COPD patients (7,8). It has been shown that pulmonary rehabilitation (PR) reduces dyspnea, enhances exercise performance, improves QOL, and decreases psychological symptoms in COPD patients (9). The present study aimed to compare the gains of PR in obese, pre-obese, and normal-weight COPD patients who completed an 8-week outpatient PR program.
AbstractObjective: We aimed to compare the gain of pulmonary rehabilitation (PR) in obese, pre-obese, and normal-weight patients with chronic obstructive pulmonary disease (COPD) who underwent a PR program.Methods: COPD patients (n=137) underwent pulmonary and cardiac system examination and pulmonary function tests (PFTs) before PR. Chest X-rays, arterial blood gases, body mass index, quality of life (QOL) questionnaires, anxiety and depression scores, and Modified Medical Research Council dyspnea scale (MMRC) scores were evaluated in all patients. A 6-min walk test was performed to determine the exercise capacity of the patients. All patients underwent an 8-week outpatient PR program. The patients were reevaluated at the end of 8th week in terms of all parameters.
Results:The study group consisted of 44 normal-weight, 52 pre-obese, and 41 obese COPD patients. Before PR, there was no significant difference in terms of 6-min walk distance (6MWD), PFT, MMRC, or QOL scores between the groups (p>0.05 for all). After PR, partial arterial oxygen pressure and arterial saturation, MMRC, and QOL scores improved significantly in all three groups (p<0.05 for all). 6MWD and walkwork significantly increased after PR in all three groups (p<0.001 for all), but the gain in 6MWD was significantly lower in obese patients compared to pre-obese and normal-weight patients (p=0.049).
Conclusion:Pre-obese and obese patients benefit from PR similarly to the normal-weight patients in terms of gas exchange, dyspnea perception, and QOL. But it seems to be that exercise capacity improves less in obese COPD patients compared to pre-o...
