PULMONARY REHABILITATION IN PATIENTS WITH COPD

Chronic Obstructive Pulmonary Disease (COPD) is now a leading cause of disability in the developed world. The progress of COPD is associated with increasing breathlessness, disability and frequent hospitalisations. An ageing population in the developed world and increasing cigarette consumption in developing countries compounds the global impact of this condition. The disability associated with COPD leads to a reduction in physical activity and loss of functional independence. The aim of this study was to investigate the effects of PR in patients with normal exercise capacity on health-related quality of life and exercise capacity. The mean FEV1/FVC was 59.4± 14.1%, and the mean FEV1 was 64.8± 23.0% of predicted. Most subjects had mild to moderate COPD. The PImax and PEmax were normal. These subjects had no previous participation in home-based or hospital-based PR. All the subjects had normal maximal V˙O2 and work rate before PR. After PR there were still significant improvements in maximal V˙O2 (mean increase of 101.3 mL/min, p <0.001) and work rate (mean increase of 8.2 watts, p<0.001). Ventilation, heart rate, and mean blood pressure were unchanged following PR. The maximum oxygen pulse at maximum exercise was significantly increased with PR (p<0.02). The SpO2 and end-tidal PCO2 at peak exercise did not significantly change after PR. Although dyspnea scores at rest were low and did not change significantly with PR, dyspnea at end-exercise was significantly improved after PR (p=0.01). PR should be part of the clinical management of patients with COPD, even for those with normal exercise capacity. However, benefits on disease progression, hospitalization, and survival for these patients remain unknown.