Effects of 3-week Outpatient Pulmonary Rehabilitation on Exercise Capacity, Dyspnea, and Quality of Life in COPD

Abstract

The effects of intensive 3-week outpatient pulmonary rehabilitation (PR) on exercise capacity, dyspnea, and health-related quality of life (HRQL) were investigated in patients with COPD. Two hundred ten patients with COPD (mean FEV(1) = 54%pred) underwent PR consisting of exercise training, patient and psychosocial education, breathing and relaxation therapy, nutrition counseling, and smoking cessation support. Before and after PR, exercise capacity was assessed with 6-min walking tests (6MWT) and constant cycle ergometer exercise (CEE). Dyspnea was measured after 6MWTs with a Borg scale and after PR with the Transition Dyspnoea Index (TDI). HRQL was examined with the Medical Outcomes Study Short Form 36 (SF-36). Results showed improvements in the 6MWT (+39 m, p < 0.001) and CEE (+241 W x min, p < 0.001) after PR, paralleled by decreased dyspnea during the 6MWT (-0.5, p < 0.001) and during activities (TDI score = 3.6). Increases in all SF-36 subscales reflected improved HRQL after PR (p < 0.001). No gender differences were found. Patients with milder versus more severe COPD improved similarly in most outcomes. Regression analyses revealed that TDI scores were the most important predictor of improvements in HRQL. The results suggest that intensive 3-week outpatient PR is associated with improvements in exercise capacity, dyspnea, and HRQL in male and female patients with COPD irrespective of COPD severity. Reduced dyspnea during activities contributed the most to improvements in HRQL.

Effect of Implementation of Teaching Modules about Physiological and Psychological Parameters on Expected Clinical Outcomes of Patients with Chronic Obstructive Pulmonary Disease

“…There was also a significant difference between the two groups at the end of the study (P = 0.0001). Moreover other studies by Reardon, et al, (2015) [45] Von Leupoldt, et al, (2008) [46] also was consistent with the result of the present study as they found that intensive 3-week outpatient pulmonary rehabilitation is associated with improvements in exercise capacity, dyspnea, and HRQL in male and female patients irrespective of COPD severity.…”

Optimal duration of pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease - a systematic review

“…In the literature, PR programs vary from as short as a few weeks 8 to as long as 3 years. 9 Clinical practice guidelines from the American College of Chest Physicians (ACCP) state that there is 'no consensus' regarding the optimal duration of pulmonary rehabilitation for patients with COPD.…”

A Prospective Observational Study on Health-Related Quality of Life in Chronic Obstructive Pulmonary Disease Patients Based on Severity

“…The most commonly used scale to measure dyspnea is MRC scale, because of its simplicity, ease of administration and established validation as a useful marker in COPD, and the study concluded that MRCS as the most suitable scale used in COPD patients [20]. Hajiro et al [21] showed that dyspnea is the main factor that separates disease-specific health-related quality of life and analyzed that it has a strong correlation with impairments in the HRQOL in COPD patients.…”