Pulmonary rehabilitation (PR) is an accepted component in the treatment of chronic obstructive pulmonary disease (COPD). Studies have shown that pulmonary rehabilitation, consisting of at least three training sessions a week, improves exercise performance and health status.We studied the effect of twice weekly PR for 12 weeks on health status, exercise capacity, and dyspnea.
Nineteen consecutive patients (9 female) age 61±16 with diagnosis of COPD, FEV1 55%±26 were included in a 12-week twice a week pulmonary rehabilitation program. The program consisted in treadmill walking or recumbent stepper for 30 minutes at 60% of the intensity attained in a maximal exercise test.The intensity was increased to maintain a perceived dyspnea of 4 according to the Borg modified dyspnea scale. Upper extremity endurance exercise was also included for up to 15 minutes every session .COPD disease education was on a one-on-one basis according to patients needs assessed by a questionnaire that measured patient’s knowledge of the disease. All patients watched tapes on exercise, breathing exercises and pulmonary rehabilitation.. Health status measured with the Pulmonary Functional Status Scale (PFSS), 6 minutes walk test and Borg score were the outcome measures of this study measured before and after the intervention.
Pre/Post rehab resultsPFSS scorePre PRPost PRP valueEffect SizeFunctional3.6+0.53.8+0.60.0950.48Psychological3.6+0.73.9+0.60.0140.38Sexuality4.0+0.94.2+0.90.30.27Total Score9.1+2.410.0+3.00.050.456 MWT390+101434+870.0010.43Dyspnea5+34.2+18.104.22.168Attendance rate 84%
Although the results showed a statistically significant improvement in exercise performance and total quality of life score, the difference was not clinically meaningful as expressed by the effect size . In particular in the post PR 6-minute walk test result did not reach the clinically meaningful difference of 54 meters.
This study failed to demonstrate that twice a week PR produce meaningful improvements in this group of COPD patients.
R.P. Benzo, None.