Should we exclude elderly patients with chronic obstructive pulmonary disease from a long-time ambulatory pulmonary rehabilitation programme?

Abstract

Objective: To assess the outcomes of a 6-month comprehensive multidisciplinary outpatient pulmonary rehabilitation programme in patients with chronic obstructive pulmonary disease according to age.

Design: Prospective cohort study.

Patients: A total of 140 patients with chronic obstructive pulmonary disease (Global Initiative for Chronic Obstructive Lung Disease (GOLD) 3-4) admitted to our centre for pulmonary rehabilitation.

Methods: Patients were divided into 3 groups: group A (< 65 years), group B (65-74 years) and group C (≥ 75 years). All the patients received an education and individualized training programme. Pulmonary rehabilitation efficacy was evaluated at 6 months of treatment and 12 months post-treatment.

Results: A total of 116 patients completed the pulmonary rehabilitation programme: 59 in group A (85.5%), 40 in group B (80%) and 17 in group C (80.9%). All the parameters studied (number of sessions, 6-min walking distance, isometric quadriceps strength, health-related quality of life, maximal load, peak oxygen uptake, maximal inspiratory and expiratory pressures) were significantly improved in each of the groups at 3 and 6 months compared with baseline. Moreover, percentage changes from baseline at 6 months for all of the parameters studied were not significantly different between age-groups.

Conclusion: Pulmonary rehabilitation is efficient in elderly patients with severe and very severe chronic obstructive pulmonary disease, and their compliance with pulmonary rehabilitation was similar to that seen in younger groups. Therefore, elderly patients with chronic obstructive pulmonary disease should not be denied pulmonary rehabilitation.