Outpatient pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Abstract

Objective: To evaluate an entirely outpatient-based program of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease COPD, using St.George's Respiratory questionnaire (SGRQ), the 6-minutes walking test (6-MWT) and BODE index as the primary outcome measures. Methods: A prospective, parallel-group controlled study of an outpatient rehabilitation program in 80 patients with COPD (67 men and 13 women; mean age 64.8 ± 10.6 years; FEV 1 , 42.8% ± 7.6% of the predicted value. The active group (n = 40) took part in a 14-week rehabilitation program [3 h/wk, 1.5 h of education and exercise and 1.5 h of cycling]. The control group (n = 40) was reviewed routinely as medical outpatients. The following evaluations were carried out at study entry and after14 weeks: (1) pulmonary function studies; (2) 6-minutes walking test 6MWT; (3) quality of life; and (4) BODE index. Results: The following patients completed the study: 35 patients (87.5%) from the active group (mean age, 63.7 ± 11.9 years; mean forced expiratory volume in one second (FEV 1), 41.9 ± 2.6% of the predicted value); and 36 patients (88%) from the control group (mean age, 65.9 ± 10.3 years; mean FEV 1 , 43.33 ± 3.6% of the predicted value). We found no changes in pulmonary function parameters in the active group and the control one at 14weeks. On the other hand, there were signifi cant changes within the components of the SGRQ (12.3 for the score total) for the patients of the active group but not for the patients of the control one (only 1.5 for the score total), we observed also a signifi cant increase in the distance of the 6-MWT in the patients of the active group but not for the patients of the control one, and fi nally a decrease of two points (from 6 to 4) was noted in the score of the active group's BODE index without any change in the control group's one. Conclusion: An outpatient-based of 14-week rehabilitation program signifi cantly improved the quality of life and exercise tolerance without any change in the pulmonary function in patients with moderate COPD, and there was also a large decrease in the risk of death in rehabilitated patients as measured using the BODE index.

Pulmonary rehabilitation programs in lung transplant: a literature review

“…The educational approach must be directed to the surgery, the professional team must prepare the patient to the intervention as well as his/her recovery that will need care and physical training follow-up in the PR (31) . The evaluation protocols of the analyzed studies (lung function, QoL, exercise capacity and quadriceps force) were similar to other studies in different patients (11,12,15,16) . Recent study (32) showed that the delay in the recovery of the exercise capacity after lung transplant is not associated with the delay in the improvement of the function of the transplanted organ but it results to the slow recovery of the muscular force.…”

“…It is a multidisciplinary program based on a thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education, and behavior change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors (10) . It aims to enhance the functional capacity (11,12) , to reduce the frequency of the exacerbations (13) and hospital admission of patients with chronic lung disease (14) and, principally, to improve their QoL (11,15,16) . Although different studies show the benefits of the PR in COPD (11,12,15,17) and others respiratory chronic diseases (10) regarding inpatient or outpatient treatment (18,19) , somewhat is known about the physical training repercussions in candidates to lung transplant or lung transplant recipients (8,9) .…”

“…It aims to enhance the functional capacity (11,12) , to reduce the frequency of the exacerbations (13) and hospital admission of patients with chronic lung disease (14) and, principally, to improve their QoL (11,15,16) . Although different studies show the benefits of the PR in COPD (11,12,15,17) and others respiratory chronic diseases (10) regarding inpatient or outpatient treatment (18,19) , somewhat is known about the physical training repercussions in candidates to lung transplant or lung transplant recipients (8,9) . Investigating PR programs in lung transplant may give a support to describe this treatment as an important allied before and after the surgery contributing to the health promotion of the patients which is the process of enabling people to increase control over, and to improve their health (20) .…”

A randomized clinical trial to assess the influence of a three months training program (Gym-based individualized vs. Calisthenics-based non-invidualized) in COPD-patients

“…The power calculation was done according to the results of Barakat et al who evaluated an outpatient training program in COPD [ 23 ]. We considered our individualized programm to be roughly equally effective (difference in 6-MWT of 46 m).…”

Development of an Integrated Virtual Group Training System for COPD Patients

“…The downward spiral of breathlessness fear, inactivity and social isolation leads to a bad physical condition (Global Initiative for Chronic Obstructive Lung Disease, 2013). To overcome this downward spiral patients can be enrolled in a pulmonary rehabilitation program (PRP) which improve the exercise capacity (Croitoru et al, 2013;Nici et al, 2006;Shahin, Germain, Pastene, Viallet, & Annat, 2008). However, most benefits deteriorate after the rehabilitation program is finished (Egan et al, 2012;Gosselink, 2002;Karapolat et al, 2007;Nici et al, 2006;Spruit, Troosters, Trappenburg, Decramer, & Gosselink, 2004).…”