Psychosocial conditions do not affect short-term outcome of multidisciplinary rehabilitation in chronic obstructive pulmonary disease.
OBJECTIVE
To characterize patients referred for pulmonary rehabilitation on a large number of psychologic and sociodemographic variables and to determine the contribution of these variables on the response to rehabilitation.


METHODS
Cross-sectional, explorative.


METHODS
University hospital and outpatient clinic.


METHODS
Eighty-one consecutive patients with chronic obstructive pulmonary disease (forced expiratory volume in 1 second, 40%+/-16% of predicted) were included in outpatient pulmonary rehabilitation.


METHODS
Multidisciplinary rehabilitation program.


METHODS
Pulmonary function, exercise capacity (Wmax, 6-minute walk test [6MWT]), Chronic Respiratory Disease Questionnaire (CRDQ), Modified Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ-M), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]) were assessed before and after 3 months rehabilitation. In addition, psychosocial adjustment, social support, marital status, mode of transportation, education, employment, and smoking status were assessed at the start of the rehabilitation.


RESULTS
Rehabilitation improved exercise performance (Wmax, 6+/-12W; P<.01; 6MWT, 41+/-72 m; P<.001), quality of life (CRDQ score, 12+/-13 points; P<.001), functional status (PFSDQ-M activity score, -8+/-11 points; PFSDQ-M dyspnea score, -6+/-12 points; PFSDQ-M fatigue score, -4+/-8 points; all P<.01), HADS anxiety score (-2+/-3 points, P<.01), and HADS depression score (-3+/-3 points, P<.001). In single regression analysis, only baseline depression was weakly negatively correlated with the change in maximal workload. No other relations of initial psychologic or sociodemographic variables with outcome were observed.


CONCLUSIONS
The effects of rehabilitation are not affected by baseline psychosocial factors. Patients with less favorable psychologic or sociodemographic conditions can also benefit from pulmonary rehabilitation. The multidisciplinary approach of the rehabilitation program might have contributed to this improvement.
Trappenburg
Jacob C
JC
Respiratory Rehabilitation and Respiratory Division, University Hospitals, Katholieke Universiteit, Leuven, Belgium.
Troosters
Thierry
T
Spruit
Martijn A
MA
Vandebrouck
Nele
N
Decramer
Marc
M
Gosselink
Rik
R
D000368:Aged; D000553:Ambulatory Care; D000704:Analysis of Variance; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011336:Probability; D011584:Psychology; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012138:Respiratory Therapy / Q000379:methods; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome