Pulmonary Rehabilitation (PR) is recommended for symptomatic patients with chronic obstructive pulmonary disease (COPD) and has a positive impact on exercise performance and quality of life (QL). However, the determinants of change in QL after PRP remain unknown. The aim of the study was to identify predictors of change in quality of life after PRP.
We included 46 stable outpatients with COPD in an 8-week multidisciplinary rehabilitation program. PRP consisted of educational sessions (once a week) and supervised exercise sessions in cycle ergometer three times a week. Spirometry, 6-minute walking distance (6MWD), dyspnea at rest and post-exertion, QL (Saint George’s Respiratory Questionnaire) and knowledge about the disease (specific questionnaire with 20 questions) were assessed before (T0) and after PRP (T1). The patients were divided into two groups depending on the change in QL: Responders (R, decrease of 4 points or more in QL after PRP) or Non-Responders (NR, less than 4 points or no change).
At T1 83% of the patients showed improvement in QL in accordance with the defined criterion. Age, gender, FEV1% of predicted, 6MWD, arterial oxygen saturation, resting and post-exertion dyspnea at T0 were not significantly different between the two groups. The R-group showed higher QL score at T0 than NR (60.4±17.3 versus 44.7±16.2; p<0.001). There was a significant correlation between QL-change after PRP and QL-score at T0 (r= -0.526, p=0.0002). A regression analysis was performed using QL-change as the dependent variable. Only age and QL score at T0 remained in the model and explained 34% of the QL-change after PRP.
Baseline QL score is the best predictor of the change in QL after PRP in COPD patients.
COPD patients with higher QL impairment at baseline have larger improvement in QL after PRP.
M.M. Knorst, None.