title: The functional impact of an individualized, graded, outpatient pulmonary rehabilitation in end-stage chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To evaluate the functional impact of an individualized outpatient pulmonary rehabilitation program in end-stage chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Patients with end-stage COPD were admitted into a 6-week comprehensive outpatient pulmonary rehabilitation program that was "packaged" for each patient. We compared spirometric parameters, exercise tolerance, level of breathlessness, and intensity of work before and after rehabilitation.
  
  
  RESULTS
  Of 45 eligible patients, only 14 consented to participate in the study. All 14 patients had forced expiratory volume in 1 second <35% of predicted, and 10 patients (72%) had a 6-minute walk test <180 m. The level of breathlessness was between 7 (moderate to severely breathless) and 10 (maximally breathless) on the Visual Analogue Scale in all patients. After the program, there was significant improvement in the FEV 1 P = 0.04), forced vital capacity P = 0.0045), 6-minute walk test P = 0.00047), and shuttle-walk test (9 of 14 patients). All patients had some improvement in level of dyspnea.
  
  
  CONCLUSIONS
  Individualized outpatient pulmonary rehabilitation in end-stage COPD can produce a measurable improvement in spirometry and exercise tolerance with a favorable impact on the level of physical activity.
authors.affiliation: Cardiothoracic Centre, Castle Hill Hospital, Cottingham, East Yorkshire HU16 5JQ, UK.
authors.forename: Dumbor L
authors.initials: DL
authors.lastname: Ngaage
authors.forename: Kirsteen
authors.initials: K
authors.lastname: Hasney
authors.forename: Micheal E
authors.initials: ME
authors.lastname: Cowen
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D004032:Diet; D004417:Dyspnea / Q000209:etiology; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000534:rehabilitation*; D016540:Smoking Cessation; D013147:Spirometry; D016896:Treatment Outcome; D014797:Vital Capacity