PURPOSE: To evaluate the changes of Bode index (BI) components, exertional dyspnea (ED), and Health-related quality of life (HRQoL) scores after repeated sessions of respiratory rehabilitation program (RRP), and correlation between them in severe COPD.
METHODS: 32 patients (age, mean ± SD, 59 ± 6 years; 21 males and 11 females) with severe COPD (GOLD 2005 criteria) completed a comprehensive 6-weeks RRP (RR1), which was repeated after 6 (RR2), 12 (RR3) and 18 months (RR4). RRP session was completed 2 weeks in the hospital and 4 weeks at home. BI components (BMI, FEV1, MMRC dyspnea score, and 6 min MWD) were determined before and after each RRP session. Patients were considered RRP responders if there was a change in BI of –1 point or more. ED was evaluated before and after each 6 min MWD with 100 mm visual analog scale (VAS). HRQoL was measured by the St. George's Respiratory Questionnaire (SGRQ) at the same moments as BI. All patients received regular treatment with inhaled bronchodilators and systemic steroids during the exacerbations.
RESULTS: After RR1, RR2, RR3 and RR4 were 26 (BI improved by 22.1 %), 24 (BI improuved by 20.5 %), 23 (BI improuved by 18.8 %) and 20 (BI improuved by 17 %). The SGRQ total scores were improved after each RRP by 12.7 %, 11.2 %, 10.9 % and 10.5 %. ED was diminished with 20.6 %, 19.8 %, 18.9 % and 17.1 % at the same moments. Significant correlation was observed between BI (particularly MMRC dyspnea score, 6 min MWD and FEV1) and SGRQ activity, symptom, impact and total score. ED presented higher correlation values with all SGRQ scores, MMRC dyspnea score and 6 min MWD, and significant correlation with BI and FEV1.
CONCLUSION: HRQoL is better correlated with exertional dyspnea and dyspnea during daily activities.
CLINICAL IMPLICATIONS: VAS and MMRC dyspnea scores may be a useful means for RRP monitoring and HRQoL indirect evaluation in the routine medical activity.
DISCLOSURE: Paraschiva Postolache, No Financial Disclosure Information; No Product/Research Disclosure Information