PURPOSE: To assess and correlate changes in exercise capacity and quality of life (QOL) in patients with obstructive lung disease (OLD) after intensive inpatient pulmonary rehabilitation (PR).
METHODS: We prospectively studied 19 consecutive patients (all male) with stable OLD (17 COPD, 2 bronchiectasis), aged 66 +/− 10 years, who completed our intensive 16-day, 18-session PR program that included education, supervised aerobic training, limb strengthening exercises and inspiratory muscle training. Before and after the PR program, patients underwent lung function tests, 6-minute walk (6MW) test, cardiopulmonary exercise test (if able to do so) as well as completed 3 QOL questionnaires. Paired Students t-test was used for before/after comparison. Pearson’s correlation coefficient was calculated for changes in outcome parameters. Statistical significance was taken as p<0.05.
RESULTS: Baseline FEV1 was 0.81 +/− 0.27L or 36% +/− 0.09% of predicted with only 1 patient above 50% of predicted. There were improvements in maximum oxygen uptake (VO2max) (14%, p=0.005) (maximum exercise capacity), 6MW distance (17%, p=0.002) (functional exercise capacity), CRDQ (26%, p<0.001), SF-36 (26%, p=0.017) and SGRQ (18%, p<0.001) (Table 1). However, there was no correlation between changes in exercise capacity and QOL, nor was there any correlation between changes in VO2max and 6MW distance (Table 2). There was significant correlation between improvements in SF-36 and CRDQ (r=0.53, p=0,027), and between improvements in SF-26 and SGRQ (−0.64, p=0.003) scores but not between improvements in CRDQ and SGRQ scores (Table 2).
CONCLUSION: Short intensive inpatient PR was effective in patients with OLD. Improvement in exercise capacity was only modest but could be due to severe ventilatory limitation. There was no correlation between improvements in exercise capacity and QOL or between improvements in maximum and functional exercise capacities. There was no correlation between 2 respiratory-specific QOL scores.
CLINICAL IMPLICATIONS: Short intensive inpatient program is an alternative to the usual 6-week program for PR. Maximum and functional exercise capacities, and QOL scores appeared to be independent outcome measures. Monitoring of multiple outcomes after PR could therefore be useful.
DISCLOSURE: Chian-Min Loo, None.