PURPOSE: To determine the effect of one year of pulmonary rehabilitation (PR) on exacerbation rates and functional parameters in patients with chronic obstructive pulmonary disease (COPD).
METHODS: This is a prospective interventional longitudinal study. A total of 97 patients were enrolled in a multidisciplinary PR program. PR included endurance, resistance, respiratory muscle training in addition to behavioural counselling and smoking cessation therapy. We assessed the number of exacerbations and exacerbation days one year before and after starting rehabilitation. Additionally, we performed a modified Bruce Test and measurements of upper and lower limb as well as inspiratory muscle strength before, 6 and 12 months after beginning rehabilitation.
RESULTS: 97 patients (44f/53m) with COPD (COPD IV-N=44, COPD III-N=39, COPD II-N=14), a mean age of 58.8±7.6 years, BMI 26.5±5.4 attended 48.6±26.3 training sessions in one year. Within 6 months, exacerbation rates dropped significantly from 2.8 to 0.8; P=0.006 and stayed low after one year, the same was true for the number of hospitalization days (from 32.8 to 0.9, P<0.001). Modified Bruce Test (from 13±7 Min to 18±9 Min; P<0.001), upper limb (from 41±3 to 57±8kg; P<0.001) and lower limb strength increased significantly (from 102±45 to 145±57kg; P<0.001). There was no improvement in FEV1 or FEV1/FVC but a significant reduction in residual volume occurred within 6 months (from 4.4±0.8 to 4.0±0.7 l; P<0.001).
CONCLUSION: One year of pulmonary rehabilitation for outpatients with COPD is a cheap and effective intervention.
CLINICAL IMPLICATIONS: One year of pulmonary rehabilitation leads to a significant improvement in exercise tolerance and quality of life in patients with COPD also reducing exacerbation rates, hospitalisation and residual volume.
DISCLOSURE: Ralf Zwick, No Financial Disclosure Information; No Product/Research Disclosure Information