Study objectives: To evaluate changes in health-related
quality of life (HRQL) as assessed by the Medical Outcomes Study Short
Form 36-item questionnaire (SF-36) after pulmonary rehabilitation and
lung volume reduction surgery (LVRS).
Prospective cohort study.
Patients: Nineteen patients
with severe emphysema who underwent pulmonary rehabilitation in
preparation for LVRS.
rehabilitation followed by bilateral sequential LVRS.
Measurements and results: HRQL assessed by the SF-36 was
measured at baseline, after pulmonary rehabilitation, and 6 months
after LVRS. One-way analysis of variance with repeated measures
demonstrated no significant change from baseline in any of the eight
domains after pulmonary rehabilitation. Scores for only one domain,
vitality, improved significantly after LVRS compared with scores after
pulmonary rehabilitation. However, significant improvements over
baseline scores were demonstrated after combined preoperative pulmonary
rehabilitation and LVRS in the domains of physical functioning, role
limitations due to physical problems, social functioning, and vitality.
Pulmonary rehabilitation contributed most to the overall improvements
in role limitations due to physical problems, whereas LVRS contributed
mainly to the overall improvements in physical functioning, social
functioning, and vitality.
Conclusions: Patients with
severe emphysema experience significant improvements in both physical
and social health status as assessed by the SF-36 after combined
pulmonary rehabilitation and LVRS. Each intervention makes unique and
complementary contributions to the overall improvements in
Abbreviations: HRQL = health-related quality of
life; LVRS = lung volume reduction surgery; r = correlation
coefficient; SF-36 = Medical Outcomes Study Short Form-36