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Pulmonary Rehabilitation |

The Effects of Pulmonary Rehabilitation on Lung Function in Patients With COPD

Francesca Gibellino, MD; Laura Mammana, MMSc
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Respiratory Diseases Unit “Cannizzaro” Hospital, Catania, Italy


Chest. 2014;146(4_MeetingAbstracts):809A. doi:10.1378/chest.1989730
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Abstract

SESSION TITLE: Physiology/PFTs/Rehabilitation Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: Pulmonary rehabilitation is a therapy that, without affecting lung function, impacts on some of other consequences of the disease. The aim of this study is to show that pulmonary rehabilitation, not only reduces symptoms, improves exercise capacity and optimizes functional status, but also impacts on lung function.

METHODS: Thirty-six patients with mild to severe COPD (23 Males and 13 Females; age 53-81 years) were evaluated after a six weeks' pulmonary rehabilitation program. The sessions included a mixture of aerobic and strength training, a combination of treadmill and bicycle ergometer; upper-extremity exercise, diaphragmatic breathing and controlled coughing exercises. All patients were assessed before and after the pulmonary rehabilitation program by spirometry, COPD Assessment Test ( CAT) and 6-min walk test (6MWT).

RESULTS: The following parameters in the 36 patents: FVC (p<0.01), FVC% predicted (p<0.0005), FEV1 (p<0.03) FEV1% predicted (p<0.001), modified Medical Research Council (mMRC) dyspnea scale (p<0.02), 6MWT (p<0.004), CAT (p<0.01), before and after pulmonary rehabilitation were significantly different. The patients were divided into two groups, according to the severity of the disease, as related to GOLD stages: stage mild-moderate with FEV1> =50% predicted; and stage severe-very severe with FEV1< 50% predicted; FVC% ( p=0.04) and FEV1% ( p= 0.004) pre and post rehabilitation were significantly different only in mild- moderate group. The patients were after divided in two groups, following the pre rehabilitation 6MWT distance: 6MWT >= 350 meters and 6MWT < 350 meters. In the first group, FVC ( p= 0.04), FVC% ( p= 0.008), FEV1% (p= 0.02), CAT ( p= 0.000), 6MWT ( p= 0.02) before and after rehabilitation were significantly different, in the second group: < 350 meters, only FVC% (p= 0.03) and FEV1% ( p= 0.007) were significantly different .

CONCLUSIONS: The significant difference in symptoms, health status and exercise capacity, as well as in lung function, before and after rehabilitation, confirms the effect of rehabilitation and its impact on lung function, this effect is related to the severity of the disease. The 6MWT distance pre- rehabilitation is not predictive of the improvement in lung function , but only in symptoms and exercise capacity.

CLINICAL IMPLICATIONS: This new evidence strengthens the previous recommendations of pulmonary rehabilitation as a standard of care for patients with COPD

DISCLOSURE: The following authors have nothing to disclose: Francesca Gibellino, Laura Mammana

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