Long-Term Effects of Outpatient Rehabilitation of COPD

Güell, Rosa; Casán, Pere; Belda, José; Sangenis, Mercedes; Morante, Luís Fernando Morales; Guyatt, Gordon; Sanchís, J.

doi:10.1097/00008483-200011000-00010

Cited by 51 publications

(82 citation statements)

References 21 publications

(35 reference statements)

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“…The mean baseline scores in our study all indicated worse health status than in two contemporary studies involving 50 and 30 patients with HF: mean MLHFQ 48.4 ± 23.0 (vs. 41.8 ± 24.9 and 44.5 ± 26.6); mean SF‐36 PCS 32.1 ± 7.7 (vs. 33.5 ± 10.7 and 32.8 ± 8.8); mean SF‐36 MCS 40.5 ± 10.8 (vs. 48.7 ± 10.3 and 46.6 ± 12.0) ,. The mean CRQ dyspnoea score of 2.8 ± 1.0 was similar to that in trials of pulmonary rehabilitation involving patients with moderate to severe COPD ,. Our results suggest that patients with both HF and COPD have significantly impaired quality of life.…”

Section: Discussioncontrasting

confidence: 52%

Bisoprolol in patients with heart failure and moderate to severe chronic obstructive pulmonary disease: a randomized controlled trial

Hawkins

MacDonald

Petrie

et al. 2009

European J of Heart Fail

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AimsHeart failure (HF) and chronic obstructive pulmonary disease (COPD) frequently coexist. No study has prospectively examined the effects of beta-blockade in those with both conditions. Methods and resultsWe randomized 27 patients with HF and coexistent moderate or severe COPD to receive bisoprolol or placebo, titrated to maximum tolerated dose over 4 months. The primary outcome was forced expiratory volume in 1 s (FEV 1 ). The study is registered with ClinicalTrials.gov, number: NCT00702156. Patients were elderly and predominantly male. Cardiovascular comorbidity, smoking history, and pulmonary function were similar in each group (mean FEV 1 1.37 vs. 1.26 L, P ¼ 0.52). A reduction in FEV 1 occurred after 4 months following treatment with bisoprolol compared with placebo (270 vs. þ120 mL, P ¼ 0.01). Reversibility following inhaled b 2 -agonist and static lung volumes were not impaired by bisoprolol. All measures of health status exhibited a consistent non-significant improvement, including the Short Form 36 physical and mental component scores (2.6 vs. 0.5 and 0.8 vs. 20.3, respectively), Minnesota Living with Heart Failure Questionnaire (22.5 vs. 3.5) and Chronic Respiratory Questionnaire (0.07 vs. 20.24). The mean number of COPD exacerbations was similar in the bisoprolol and placebo groups (0.50 and 0.31, respectively, P ¼ 0.44). ConclusionInitiation of bisoprolol in patients with HF and concomitant moderate or severe COPD resulted in a reduction in FEV 1 . However, symptoms and quality of life were not impaired.--

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Section: Discussioncontrasting

confidence: 52%

Bisoprolol in patients with heart failure and moderate to severe chronic obstructive pulmonary disease: a randomized controlled trial

Hawkins

MacDonald

Petrie

et al. 2009

European J of Heart Fail

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“…Studies that have shown a mean improvement in 6MWD (between 52 and 80 m) resulting from an initial PR of 8 weeks, 12 weeks and 6 months duration maintained exercise capacity and HRQoL for 12 months in patients with COPD and ILD . On the other hand, studies of PR of 6–8 week's duration that reported small improvements of 11, 14 and 23 m did not maintain exercise capacity and HRQoL for 12 months.…”

Section: Initial Pr Programmementioning

confidence: 92%

“…Follow‐up assessments after the completion of PR programmes were included in a number of studies and provided the opportunity for monitoring of progress, verbal encouragement and support to keep exercising . Participants who had completed a 12‐month maintenance study (intervention of supervised weekly exercise compared to control of unsupervised home exercise) completed a survey about their experiences.…”

Section: Strategies To Improve Adherence To Maintenance Exercise Traimentioning

confidence: 99%

Maintaining the benefits following pulmonary rehabilitation: Achievable or not?

Spencer

McKeough

2019

Respirology

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Pulmonary rehabilitation (PR) improves exercise capacity, health-related quality of life (HRQoL) and dyspnoea in patients with COPD and other lung conditions. Once PR is completed, the benefits gained begin to decline unless patients continue to exercise regularly. Due to limited evidence in other lung conditions, this review aims to examine the current evidence regarding maintenance exercise programmes for patients with COPD and to determine the types of programmes that are able to maintain the benefits gained from PR to 12 months and longer. A number of factors may affect the ability to maintain exercise capacity and HRQoL in the long term including: frequency of supervised maintenance exercise; strategies used to improve adherence to maintenance exercise; facilitators and barriers to long-term exercise training; and initial PR programme itself. The current evidence for maintenance exercise programmes that included supervised maintenance exercise was weak, and for those programmes that included unsupervised maintenance exercise (with and without support) were difficult to interpret and in many instances were no better than usual care. New research using technology has provided some promising results for the future and surveys have revealed important features that may help in the development of maintenance programmes from a participant perspective such as ongoing therapist support. How to best maintain the benefits gained from PR remains unclear. Therefore, it is likely that no one model of maintenance is ideal for all patients with COPD and that individually adapted maintenance exercise programmes need to be considered.

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“…Una crítica constante a la RR es el hecho de que los beneficios alcanzados se pierden de forma progresiva una vez que el paciente finaliza el tratamiento. La gravedad de la obstrucción bronquial 13,20,41-43 y la intensidad, duración o ubicación de los programas 12,20,[41][42][43][44][45][46][47][48][49][50][51][52][53] no parecen influir en el mantenimiento de los resultados (tablas V y VI). Sin embargo, la evolución de la enfer-medad, la existencia de comorbilidad 44 y, sobre todo, la aplicación o no de técnicas de mantenimiento sí influyen.…”

Section: Beneficios Probados De La Rehabilitación Respiratoriaunclassified