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. 2010 Sep-Oct;17(5):219-23.
doi: 10.1155/2010/203236.

Success in pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Adrienne S Scott  1 , Marcel A Baltzan, Joel Fox, Norman Wolkove
Affiliations

Success in pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Adrienne S Scott et al. Can Respir J. 2010 Sep-Oct.

Abstract
in English, French

Background: Pulmonary rehabilitation (PR) is beneficial for some, but not all, patients with chronic lung disease.

Objectives: To determine the success rate of a comprehensive PR program for patients with chronic obstructive pulmonary disease (COPD) and to characterize the differences between responders and nonresponders.

Methods: A chart review was performed on patients with a clinical diagnosis of COPD who were referred for PR. Success was defined according to clinically important changes in St George's Respiratory Questionnaire scores and⁄or 6 min walk test distance.

Results: The majority of subjects were men (58%) with a mean (± SD) age of 69±10 years (n=177). Sixty-two per cent of participants had a successful outcome with PR, with proportionally more responders noting subjective improvement than objective improvement on a 6 min walk test (73% versus 51%). Subjects with poor baseline St George's Respiratory Questionnaire scores tended to improve the most (P=0.011 [ANOVA]). Successful participants had a greater forced expired volume in 1 s (1.1 L versus 0.9 L; P<0.05) and a lower BODE index (body mass index, airflow obstruction, dyspnea, and exercise capacity index) at baseline (9.6 versus 10.3; P<0.05). Success of PR was not correlated with age, sex, chronic hypoxemic respiratory failure or other chronic conditions. Successful participants were more likely to be compliant and to experience fewer adverse events (P≤0.001).

Conclusions: Our study reinforced the belief that the majority of participants with COPD benefit from PR. Few baseline characteristics were predictive of success. Subjectively measured improvement occurred more frequently than objectively measured improvement and was greatest in those with the poorest baseline values.

HISTORIQUE :: La réadaptation pulmonaire (RP) est bénéfique pour certains patients ayant une maladie pulmonaire chronique, mais pas pour tous.

OBJECTIFS :: Déterminer le taux de succès d’un programme de RP complet destiné aux patients ayant une maladie pulmonaire obstructive chronique (MPOC) et caractériser les différences entre les répondants et les non-répondants.

MÉTHODOLOGIE :: Les chercheurs ont procédé à l’examen des dossiers de patients ayant un diagnostic clinique de MPOC aiguillés en RP. Le succès était défini par des changements cliniques importants aux indices du questionnaire respiratoire de St George ou à la distance à l’épreuve de 6 minutes sur tapis roulant.

RESULTATS :: La majorité des sujets étaient des hommes (58 %) à l’âge moyen (±ÉT) de 69±10 ans (n=177). Chez 62 % des participants, la RP donnait de bons résultats, proportionnellement plus de répondants remarquant une amélioration subjective à l’épreuve de 6 minutes sur tapis roulant (73 % par rapport à 51 %). Les sujets aux indices de départ médiocres au questionnaire respiratoire de St George tendaient être ceux qui s’amélioraient le plus (P=0,011 [ANOVA]). Les participants qui profitaient de la RP avaient un meilleur volume expiratoire maximal par seconde (1,1 L par rapport à 0,9 L; P<0,05) et un indice BODE plus faible (indice de masse corporelle, obstruction des voies aériennes, dyspnée et indice de capacité à l’exercice) au départ (9,6 par rapport à 10,3; P<0,05). Le succès de la RP n’était pas corrélé à l’âge, au sexe, à l’insuffisance respiratoire hypoxémique ou à d’autres maladies chroniques. Les participants profitant de la RP étaient plus susceptibles de respecter le traitement et de vivre moins de réactions indésirables (P≤0,001).

CONCLUSIONS :: La présente étude étaye la croyance selon laquelle la majorité des participants ayant une MPOC profitent de la RP. Peu de caractéristiques de départ était prédictives de succès. L’amélioration mesurée subjectivement était plus fréquente que l’amélioration mesurée objectivement et était plus importante chez les patients ayant les valeurs de départ les plus médiocres.

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Figures

Figure 1)
Figure 1)
Study flow diagram. COPD Chronic obstructive pulmonary disease
Figure 2)
Figure 2)
The mean improvement in St George’s Respiratory Questionnaire (SGRQ) scores after pulmonary rehabilitation in relation to baseline measures of SGRQ according to quartile from best to worst
See this image and copyright information in PMC

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