Pulmonary Rehabilitation: Pulmonary Rehabilitation |

Comorbidities and Pulmonary Rehabilitation in Patients With Chronic Obstructive Pulmonary Disease FREE TO VIEW

Paraschiva Postolache, PhD; Adeline Tintila; Ana Maria Mantea, MD; Maria Roxana Nemes, PhD; Oana Claudia Deleanu, PhD; Liliana Chelariu, RT; Cristina Lacatusi; Daniela Husanu; Narcisa Vrinceanu, PhD
Author and Funding Information

“Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A487. doi:10.1016/j.chest.2016.02.508
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SESSION TITLE: Pulmonary Rehabilitation

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: Chronic obstructive pulmonary disease (COPD) is a global burden, a systemic disease that is often associated with cardiovascular and metabolic comorbidities, osteoporosis and anxiety or depression etc. The favorable effects of pulmonary rehabilitation (PR) in COPD patients are well known. The purpose is to evaluate the comorbidities frequently associated in patients with COPD and their influence on the results of PR programs.

METHODS: 120 patients hospitalized with stable COPD, GOLD stages II, III and IV, aged between 43 and 90 years, enrolled in the PR program that were divided into two age groups according to the median age of 67 years. The pieces of information about comorbidities were obtained using the Charlson Index and the COPD-specific comorbidity test that were applied before starting the PR program. The efficacy of the PR programs results (dyspnea, exercise capacity, body mass index (BMI), quality of life etc.) was shown using the BODE Index, the 6-minute walk tests (6MWT) and oximetry, the dyspnea scales (Borg and Modified Medical Research Council - mMRC), the COPD Assessment Test (CAT).

RESULTS: Most patients had at least one chronic comorbidity. Of these, the cardiovascular ones prevailed, hypertension being the most commonly reported comorbidity (78.5%), followed by metabolic diseases (67.5%), other respiratory disorders (54.9%) and anxiety/depression (10.0%). 110 of the 120 patients (91.6%) experienced a clinically significant improvement in distance in the 6MWT, with over 54 meters. 52.1%, 87.1%, 98.0% and 86.2% of the patients had reductions in the BMI, the scores of the CAT, breathlessness, anxiety and depression (assessed with the Hospital Anxiety and Depression Scale), parameters that correlated well with the improvement in the walking distance in the both two groups of patients. Multiple logistic regression analysis showed that respiratory failure and ischemic heart disease adversely affect the health status of these patients, especially shortness of breath, anxiety and depression.

CONCLUSIONS: PR is equally effective in older and young patients with COPD and chronic comorbidities, its effectiveness being influenced by the BMI and anxiety/depression. The results suggest that also patients with COPD and comorbidities have to be included in PR programs for specific training.

CLINICAL IMPLICATIONS: The optimal PR treatment of COPD should also include initial evaluation of the comorbidities in order to tailor the individual program of PR depending also on their presence.

DISCLOSURE: The following authors have nothing to disclose: Paraschiva Postolache, Adeline Tintila, Ana Maria Mantea, Maria Roxana Nemes, Oana Claudia Deleanu, Liliana Chelariu, Cristina Lacatusi, Daniela Husanu, Narcisa Vrinceanu

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