Pulmonary Rehabilitation |

The Effects of Nutritional Supplementation Combined With Conventional Pulmonary Rehabilitation in Muscle Wasted Chronic Obstructive Pulmonary Disease: A Prospective, Randomized, and Controlled Study FREE TO VIEW

Alev Gurgun, MD; Sami Deniz, MD; Mehmet Argin, MD; Hale Karapolat, MD
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Ege Univeristy Medical Faculty Department of Chest Diseases, Izmir, Turkey

Chest. 2013;144(4_MeetingAbstracts):832A. doi:10.1378/chest.1701502
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SESSION TITLE: Physiology/PFTs/Rehabilitation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 30, 2013 at 01:30 PM - 02:30 PM

PURPOSE: Nutritional depletion in COPD adversly affects health status and mortality. We aimed to evaluate the effects of nutritional supplementation (NS) with pulmonary rehabilitation (PR) on body composition, mid-thigh cross-sectional area (CSA), dyspnea, exercise capacity, HRQoL, anxiety and depression in advanced COPD patients.

METHODS: Forty-six patients were randomised to PRNS, PR or the control group. Dyspnea was measured with Medical Research Council (MRC) and BORG scales. Exercise capacity was measured through 6MWT and shuttle tests, HRQoL was assessed with SGRQ. Psychological status was measured with Hospital Anxiety and Depression Scale. Body weight and body mass indexes were also evaluated. Fat free mass was measured through bioelectrical impedance analyzer. The CSA of quadriceps was calculated in mid-level of the thigh with magnetic resonance imaging.

RESULTS: Dyspnea and total scores of SGRQ improved in both groups (p<0.05). 6MWT and ISWT distances in PRNS and PR patients increased significantly as 62.6±42.4m, 43.3±59.2m, both p=0.001 and 63.3±70.1m and 69.3±69.7m, both p=0.001. Although anxiety improved in both groups (p<0.05), there was no change in depression. Body weight, BMI and FFMI (1.1±0.9 kg, 0.2±1.4 kg/m2 and 0.6±0.5 kg/m2, p<0.05) in PRNS whereas body weight and FFMI (0.6±0.7 kg, 0.1±0.6 kg/m2 p<0.05) increased in PR after the intervention. There was a significant increase in mid-thigh CSA (2.5±4.1 cm2) only in PRNS (p=0.04).

CONCLUSIONS: The combination of NS with PR resulted improvements particularly in lean body mass and mid-thigh CSA. This study suggests combining NS with PR in reversing weight loss and muscle wasting in COPD.

CLINICAL IMPLICATIONS: Nutritional support during pulmonary rehabilitation improves many outcomes particularly quadriceps muscle area and anthropometric parameters. Therefore it is recommended during pulmonary rehabilitation programs to improve muscle mass

DISCLOSURE: The following authors have nothing to disclose: Alev Gurgun, Sami Deniz, Mehmet Argin, Hale Karapolat

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