scholarly journals Success in Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

2010 ◽  
Vol 17 (5) ◽  
pp. 219-223 ◽  
Author(s):  
Adrienne S Scott ◽  
Marcel A Baltzan ◽  
Joel Fox ◽  
Norman Wolkove
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Airflow Obstruction ◽  
Successful Outcome ◽  
Chronic Obstructive ◽  
Walk Test ◽  
Hypoxemic Respiratory Failure ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire

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.

scholarly journals The responsiveness of the Manchester Chronic Obstructive Pulmonary Disease Fatigue Scale to pulmonary rehabilitation

2019 ◽  
Vol 10 ◽  
pp. 204062231988220 ◽  
Author(s):  
Abebaw Mengistu Yohannes ◽  
Sheila Dryden ◽  
Nicola Alexander Hanania
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Medical Research Council ◽  
Chronic Obstructive ◽  
Walk Test ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire ◽  
The Mean

Background: We examined the responsiveness of the Manchester Chronic Obstructive Pulmonary Disease (COPD) Fatigue Scale (MCFS) in patients with COPD following 8 weeks of pulmonary rehabilitation (PR). Methods: Patients ( n = 273) with clinically stable COPD completed 8 weeks of outpatient multidisciplinary PR, comprising 2 h (1 h exercise and 1 h education) weekly. Anxiety, exercise capacity, quality of life, dyspnea, fatigue were measured pre- and post-PR, utilizing the Anxiety Inventory for Respiratory Disease (AIR), Incremental Shuttle Walk Test (ISWT), St. George’s Respiratory Questionnaire (SGRQ), and modified Medical Research Council (mMRC) scale and MCFS, respectively. Results: The mean (SD) age of participants was 72 (8) years, and 50% were women. Total MCFS score fell after PR mean (95% confidence interval) −4.89 (–7.90 to −3.79) as did domain scores: physical −1.89 (–2.33 to −1.46), cognition −1.37 (–1.65 to −1.09), and psychosocial −1.62 (–2.00 to −1.62). Total MCFS effect size (ES) was 0.55; and for domains, physical was 0.52, cognition was 0.59, and psychosocial was 0.51. The ES for AIR was 0.30, mMRC was 0.38, SGRQ was 0.66, and ISWT was 1.19. MCFS changes correlated with changes in both SGRQ ( p < 0.002) and AIR ( p < 0.004), but not ISWT ( p = 0.30) or mMRC ( p = 0.18). The AIR, SGRQ, mMRC, and ISWT all improved after PR (all, p < 0.001). Conclusion: The MCFS scale is a valid and responsive scale to measure fatigue in patients with COPD after pulmonary rehabilitation.

scholarly journals Fatigue and multidimensional disease severity in chronic obstructive pulmonary disease

2010 ◽  
Vol 5 ◽  
Author(s):  
Deniz Inal-Ince ◽  
Sema Savci ◽  
Melda Saglam ◽  
Ebru Calik ◽  
Hulya Arikan ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Disease Severity ◽  
Airflow Obstruction ◽  
Muscle Endurance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Peripheral Muscle ◽  
St George's Respiratory Questionnaire

Background and aims: Fatigue is associated with longitudinal ratings of health in patients with chronic obstructive pulmonary disease (COPD). Although the degree of airflow obstruction is often used to grade disease severity in patients with COPD, multidimensional grading systems have recently been developed. The aim of this study was to investigate the relationship between perceived and actual fatigue level and multidimensional disease severity in patients with COPD. Materials and methods: Twenty-two patients with COPD (aged 52-74 years) took part in the study. Multidimensional disease severity was measured using the SAFE and BODE indices. Perceived fatigue was assessed using the Fatigue Severity Scale (FSS) and the Fatigue Impact Scale (FIS). Peripheral muscle endurance was evaluated using the number of sit-ups, squats, and modified push-ups that each patient could do. Results: Thirteen patients (59%) had severe fatigue, and their St George’s Respiratory Questionnaire scores were significantly higher (p < 0.05). The SAFE index score was significantly correlated with the number of sit-ups, number of squats, FSS score and FIS score (p < 0.05). The BODE index was signif- icantly associated with the numbers of sit-ups, squats and modified push-ups, and with the FSS and FIS scores (p < 0.05). Conclusions: Peripheral muscle endurance and fatigue perception in patients with COPD was related to multidimensional disease severity measured with both the SAFE and BODE indices. Improvements in perceived and actual fatigue levels may positively affect multidimensional disease severity and health status in COPD patients. Further research is needed to investigate the effects of fatigue perception and exercise training on patients with different stages of multidimensional COPD severity.

scholarly journals Efficacy Of Unsupervised Home-Based Pulmonary Rehabilitation For Patients With Chronic Obstructive Pulmonary Disease

2020 ◽  
Author(s):  
Jang Ho Lee ◽  
Hyang Yi Lee ◽  
Youngwon Jang ◽  
Jae Seung Lee ◽  
Yeon-Mok Oh ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Airflow Obstruction ◽  
The Body ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Bode Index ◽  
Home Based ◽  
Hospital Visits

Abstract Background: Pulmonary rehabilitation (PR) is a well-established treatment for chronic obstructive pulmonary disease (COPD). The standard protocol for PR requires frequent hospital visits, which can be difficult for patients. We performed this study to assess whether unsupervised home-based PR (HBPR) is effective for patients with COPD.Methods: This investigation was a prospective cohort study. After assessing the outcome data, including the results of a COPD assessment test (CAT); the body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) index; a pulmonary function test; the modified Medical Research Council (mMRC) dyspnea scale; and the 6-min walking test (6MWT), specialists imparted education to patients about unsupervised HBPR. Patients who exercised more than three times per week were classified as the compliant group, and the others were categorized as the noncompliant group. Changes in the outcomes were compared between the compliant and noncompliant groups.Results: 41 patients were enrolled in this study. After 8 weeks of unsupervised HBPR, there were significant improvements in CAT scores, BODE index, and forced expiratory volume in 1 s among patients in the compliant group compared with those in the noncompliant group. Moreover, their CAT and mMRC scores improved significantly after 8 weeks compared with those at baseline. On the other hand, patients in the noncompliant group showed no significant improvement in any of the outcomes.Conclusions: Unsupervised HBPR can be effective for compliant patients with COPD. We recommend unsupervised HBPR for patients with COPD even when regular hospital visits for PR are not possible.Trial registration: NCT03754881

Objectively Measured Steps/Day in Patients With Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 13 (11) ◽  
pp. 1275-1283 ◽  
Author(s):  
Travis Saunders ◽  
Nerissa Campbell ◽  
Timothy Jason ◽  
Gail Dechman ◽  
Paul Hernandez ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Airflow Obstruction ◽  
Forced Expiratory Volume ◽  
Activity Level ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Objectively Measured

Background:Although individual studies have reported on the number of steps/day taken by individuals with chronic obstructive pulmonary disease (COPD), this evidence has not been systematically reviewed or synthesized.Methods:MEDLINE and PsycINFO were searched for studies reporting objectively-measured steps/day and percent predicted forced expiratory volume in 1 second (FEV1%) in patients with COPD. Meta-analyses were used to estimate steps/day across studies, while metaregression was used to estimate between-study variance based on clinical and demographic factors (year and location of study, activity monitor brand, number of days wearing the monitor, whether participants were about to enter pulmonary rehabilitation, 6-minute walk distance (6MWD), FEV1%, age, and sex).Results:38 studies including 2621 participants met inclusion criteria. The pooled mean estimate was 4579 steps/day (95% CI:4310 to 5208) for individuals with COPD. Only 6MWD, FEV1% and whether patients were about to undergo pulmonary rehabilitation explained a significant portion of the variance (P < 0.1) in univariate meta-regression. In a multivariate model including the above risk factors, only FEV1% was associated with steps/day after adjustment for other covariates.Conclusions:These results indicate that patients with COPD achieve extremely low levels of physical activity as assessed by steps/day, and that severity of airflow obstruction is associated with activity level.

scholarly journals The minimal important difference for the endurance shuttle walk test in individuals with chronic obstructive pulmonary disease following a course of pulmonary rehabilitation

2019 ◽  
Vol 16 ◽  
pp. 147997311985382 ◽  
Author(s):  
Jakub Zatloukal ◽  
Sarah Ward ◽  
Linzy Houchen-Wolloff ◽  
Theresa Harvey-Dunstan ◽  
Sally Singh
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Minimal Important Difference ◽  
Chronic Obstructive ◽  
Global Rating ◽  
Walk Test ◽  
Distribution Method ◽  
Obstructive Pulmonary Disease ◽  
A Value

The endurance shuttle walk test (ESWT) is frequently used as an outcome measure for pulmonary rehabilitation (PR). The minimal important difference (MID) for the ESWT after a course of rehabilitation has not been conclusively confirmed in the literature. The aim was to establish the MID for the ESWT following the 6-week PR programme in patients with chronic obstructive pulmonary disease (COPD). Following the completion of the 6-week PR programme, data from 531 participants were included in the analysis to estimate the MID for the ESWT using both anchor-based and distribution-based methods. Mean age (standard deviation (SD)) was 69.4 (9.1) years, 303 male, FEV1/FVC 0.51 (0.16). The baseline incremental shuttle walk test (ISWT) was 217.7 (SD 139.8) metres and ESWT 195.8 (SD 118.8) seconds, which increased to 279.6 (SD 149.5) metres and 537.4 (SD 378.3) seconds, respectively, following PR. The mean change was 61.8 (95% confidence interval (CI) 56.0–67.5) metres for the ISWT and 342.0 (95% CI 312.4–371.6) seconds for the ESWT. The distribution method (0.5 × SD) yielded an MID of 173.7 seconds, the global rating of change scale method yielded a value of 279.2 (95% CI 244.9–313.5) seconds for those rating themselves as ‘slightly improved’ and the ROC method 207 seconds. There was no agreement between the approaches employed. However, we propose that the MID for the ESWT in COPD following a 6-week PR programme is between 174 and 279 seconds.

scholarly journals Risk factors as outcome predictors of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

2021 ◽  
pp. 88-88
Author(s):  
Danijela Kuhajda ◽  
Ivan Kuhajda ◽  
Miroslav Ilic ◽  
Sinisa Maksimovic ◽  
Jelena Crnobrnja ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Positive Outcome ◽  
Disease Stage ◽  
Successful Outcome ◽  
Stable Phase ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Introduction/Objective. Chronic obstructive pulmonary disease (COPD) is a primary lung disease. Today, pulmonary rehabilitation (PR) is the basis of non-pharmacological treatment of these patients, with numerous confirmed effects on the most significant symptoms of the disease and quality of life (QoL). The aim of this study was to determine the relationship between certain risk factors and the outcome of PR, as well as to determine the percentage of respondents who had a positive outcome of PR. Methods. The study included 500 patients with COPD, determined according to the guidelines of the GOLD, all stages I-IV, in the stable phase of the disease, who completed the outpatient PR program. Disease stage, comorbidities, forced expiratory volume in the first second, 6-minute walk test (6MWT), COPD Assessment Test (CAT) and Medical Research Council dyspnea scale, BODE index, were measured before and after the program. The last four parameters have been observed as risk factors that affect the outcome of PR, but also as parameters by which we monitor the outcome of PR. Results. A successful outcome of PR was achieved by as many as 452 (90.4%) patients. As independent predictors of a positive outcome of PR were determined: lower number of comorbidities, absence of heart failure, higher BMI and CAT ? 10. Conclusions. PR in our group of patients leads to statistically significant improvements in most of the examined subjective and objective parameters, in patients at all stages of the disease.

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