title: Comprehensive pulmonary rehabilitation according to severity of COPD.
abstract: A new classification for the severity of COPD was proposed at GOLD 2003: stage I: FEV(1) > or = 80% predicted; stage II: 50% < or = FEV(1)<80%; stage III: 30% < or = FEV(1)<50%; and stage IV: FEV(1) < 30%. To elucidate the acute effects of pulmonary rehabilitation (PR) on patients with different stages of COPD, data on pulmonary function, arterial blood gas analysis, the 6-min walk test, respiratory muscle strength, and activities of daily living were analyzed before and after our comprehensive 4- to 8-week inpatient PR program between 1992 and 2003. A total of 225 patients (201 men and 24 women; 21 with stage II, 79 with stage III, and 125 with stage IV COPD) was assessed. There were significant differences in FEV(1)% predicted and % residual volume in stages III and IV, in % vital capacity in stages II, III and IV, and in % total lung capacity in stage II when comparing the changes between pre- and post-PR. Significant differences of PaO(2) in stages III and IV and PaCO(2) in stage IV were found when comparing the changes between pre- and post-PR. The 6-min walk distance was significantly increased after PR by an average of approximately 50m for all staged patients. Respiratory muscle strength was also significantly increased in stages III and IV. Activities of daily living were significantly improved in all stages. These results showed that patients with COPD had benefited from PR regardless of disease severity. The effects included improvement in pulmonary function, arterial blood gas analysis, 6-min walk distance, respiratory muscle strength, and activities of daily living although there were some differences among the three stages.
authors.affiliation: Department of Internal Medicine, National Hospital Organization, Minami-Okayama Medical Center, 4066 Hayashima, Okayama, Japan. ntakigaw@md.okayama-u.ac.jp
authors.forename: Nagio
authors.initials: N
authors.lastname: Takigawa
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Tada
authors.forename: Ryo
authors.initials: R
authors.lastname: Soda
authors.forename: Syuji
authors.initials: S
authors.lastname: Takahashi
authors.forename: Noriko
authors.initials: N
authors.lastname: Kawata
authors.forename: Takuo
authors.initials: T
authors.lastname: Shibayama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Noboru
authors.initials: N
authors.lastname: Hamada
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hirano
authors.forename: Goro
authors.initials: G
authors.lastname: Kimura
authors.forename: Chiharu
authors.initials: C
authors.lastname: Okada
authors.forename: Shigeto
authors.initials: S
authors.lastname: Endo
authors.forename: Motohiro
authors.initials: M
authors.lastname: Yamashita
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide / Q000502:physiology; D005080:Exercise Test / Q000379:methods; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010100:Oxygen / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D012132:Respiratory Muscles / Q000503:physiopathology; D012138:Respiratory Therapy / Q000379:methods; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology; D016138:Walking / Q000502:physiology
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen