title: Length and clinical effectiveness of pulmonary rehabilitation in outpatients with chronic airway obstruction.
abstract: OBJECTIVE
  To assess the clinical effectiveness of pulmonary rehabilitation (PR) after 10 or 20 consecutive sessions in outpatients with chronic airway obstruction (CAO).
  
  
  METHODS
  Observational prospective cohort trial.
  
  
  METHODS
  Outpatient clinic of a rehabilitation center.
  
  
  METHODS
  Twenty-five outpatients (mean age, 65 +/- 9 years [+/- SD]; FEV1, 64 +/- 12% predicted) admitted to a comprehensive PR program, including exercise training.
  
  
  RESULTS
  The load reached on a cycloergometer (maximal achieved load [W-max]), the maximal and isoload dyspnea and leg fatigue on a Borg scale, 6-min walk distance (6MWD), and the health-related quality of life as assessed using the St. George's Respiratory Questionnaire (SGRQ) [total and components score] have been recorded as outcome measures at baseline, after 10 sessions (T10), and after 20 sessions (T20). The predefined criteria of the clinically significant improvement were as follows: + 15% W-max, + 54 m at 6MWD, - 1 point at isoload dyspnea and leg fatigue, and - 4% at SGRQ scores. There was a mean significant difference between changes at T20 and T10 for 6MWD (- 42.96 m; 95% confidence interval [CI], - 57.79 to - 28.12 m; p = 0.001), total SGRQ (4.80; 95% CI, 2.29 to 7.31; p = 0.001), activity SGRQ (3.60; 95% CI, 0.48 to 6.71; p = 0.025), and symptoms SGRQ (5.96; 95% CI, 2.72 to 9.2; p = 0.001). The percentage of patients who improved was different at T20 as compared with T10 for W-max (68% and 48%, respectively; p = 0.025), 6MWD (76% and 20%, p = 0.001), and total SGRQ (64% and 36%, p = 0.008).
  
  
  CONCLUSIONS
  A 10-session course of PR provides only limited clinically significant changes of outcome measures when compared with a 20-session course in outpatients with CAO of mild-to-moderate severity.
authors.affiliation: Fondazione Villa Pineta, and University of Modena-Reggio Emilia, Division of Pneumology & Pulmonary Rehabilitation, Pavullo (MO), Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Rossi
authors.forename: Fabio
authors.initials: F
authors.lastname: Florini
authors.forename: Micaela
authors.initials: M
authors.lastname: Romagnoli
authors.forename: Tommasina
authors.initials: T
authors.lastname: Bellantone
authors.forename: Sasa
authors.initials: S
authors.lastname: Lucic
authors.forename: Daniela
authors.initials: D
authors.lastname: Lugli
authors.forename: Enrico
authors.initials: E
authors.lastname: Clini
mesh_terms: D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D012046:Rehabilitation / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome