Effectiveness of pulmonary rehabilitation in COPD patients receiving long-term oxygen therapy

Abstract

Aim: It has been demonstrated that long-term oxygen therapy increased exercise capacity, improved the quality of life, reduced hospitalization and increased life expectancy in chronic hypoxemic COPD patients. The present study aims to evaluate the effectiveness of pulmonary rehabilitation (PR) in COPD patients receiving long-term oxygen therapy (LTOT) compared to COPD patients not receiving LTOT.

Materials and methods: Chronic hypoxemic COPD patients using LTOT (LTOT group) and COPD patients not receiving LTOT (non-LTOT group) who participated in this study underwent a comprehensive 8-week outpatient PR program.

Results: Twenty-seven out of 61 severe/very severe cases with COPD received LTOT at home, and 34 did not. After PR, 6-minute walking distance (6mWD) increased significantly and perceived dyspnea decreased significantly in both groups (P < .001, both). This change was significantly higher in the LTOT-receiving group compared to the non-LTOT Group (P = .046, P = .012). In both groups, all items in the disease-related quality of life questionnaire (QoL) were improved, and the scores in the health-related QoL questionnaire exhibited an improvement (P < .05, for all). Anxiety and depression scores were significantly lowered in both groups (P < .05, both).

Conclusions: Those COPD patients receiving the LTOT benefited from the PR as much as those COPD patients not receiving LTOT. The former group had a higher increase in 6mWD and a higher reduction in dyspnea symptoms. Further studies are required to understand to what extent the severe chronic hypoxemic COPD patients could benefit from the PR.

Keywords: 6mWD; COPD; dyspnea; long term oxygen therapy; pulmonary rehabilitation; quality of life.