title: Improved quality of life among patients completing a pulmonary rehabilitation program: one center's early experience.
abstract: BACKGROUND
  The conclusion of previous investigations that pulmonary rehabilitation (PR) is an effective intervention for the management of chronic lung disease may not be generalizable to PR programs with limited experience delivering this complex, interdisciplinary service.
  
  
  OBJECTIVE
  Determine whether PR is effective for the first group of patients treated in a newly formed interdisciplinary PR program.
  
  
  METHODS
  We conducted a longitudinal analysis of changes in health-related quality of life and 6-minute walk test for the first group of patients completing our newly formed 8-week outpatient PR program. We studied 6 men, age 65-77 years, with stable severe chronic obstructive pulmonary disease. Patients completed the Chronic Respiratory Disease Questionnaire immediately before and 1 year after participation in our PR program.
  
  
  RESULTS
  Four patients completed the PR 6-minute walk test both before and after the program. We found improvement in all Chronic Respiratory Disease Questionnaire domains at follow-up (mean +/- SD before and after): dyspnea 1.67 +/- 0.82 vs 4.92 +/- 0.49; emotional function 2.33 +/- 0.82 vs 5.50 +/- 0.55; fatigue 2.00 +/- 0.63 vs 5.00 +/- 0.63; feeling of mastery over disease 1.83 +/- 0.41 vs 5.83 +/- 1.17. The interval improvements in all health-related quality of life domains were statistically significant (p < 0.02 for all comparisons). There was a trend toward improvement in exercise tolerance: 231 +/- 213 ft before PR vs 353 +/- 66 ft at the 1-year follow-up (p = 0.2).
  
  
  CONCLUSIONS
  PR can result in sustained improvement in the quality of life of patients with severe chronic obstructive pulmonary disease, even when this complex, interdisciplinary service is delivered by a newly formed and inexperienced PR program.
authors.affiliation: Pulmonary Section, Veterans Affairs Palo Alto Health Care System, 3801 Miranda Avenue, Mail Stop 111P, Palo Alto, CA 94304, USA.
authors.forename: S
authors.initials: S
authors.lastname: Shafazand
authors.forename: J
authors.initials: J
authors.lastname: Canfield
authors.forename: W G
authors.initials: WG
authors.lastname: Kuschner
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005081:Exercise Therapy / Q000458:organization & administration*; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D008173:Lung Diseases, Obstructive / Q000523:psychology* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration*; D010353:Patient Education as Topic / Q000458:organization & administration*; D015397:Program Evaluation; D011788:Quality of Life; D012138:Respiratory Therapy; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome