Efficacy of pulmonary rehabilitation in chronic respiratory failure (CRF) due to chronic obstructive pulmonary disease (COPD): The Maugeri Study.
While the effectiveness of pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) is well established, its effectiveness in the most severe category of COPD, i.e. patients with chronic respiratory failure (CRF), is less well known.


OBJECTIVE
To verify the effects of PR in patients with CRF, and compare the level of improvement with PR in these patients to that of COPDs not affected by CRF.


METHODS
A multi-centre study was carried out on COPD patients with versus without CRF. The PR program included educational support, exercise training, and nutritional and psychological counselling. Lung function, arterial gases, walk test (6MWT), dyspnoea (MRC; BDI/TDI), and quality of life (MRF(28); SGRQ) were evaluated.


RESULTS
Thousand forty seven consecutive COPD inpatients (327 with CRF) were evaluated. In patients with CRF all parameters improved after PR (0.001). Mean changes: FEV(1), 112 ml; PaO(2), 3.0 mmHg; PaCO(2), 3.3 mmHg; 6MWT, 48 m; MRC, 0.85 units; MRF(28) total score, 11.5 units. These changes were similar to those observed in patients without CRF.


CONCLUSIONS
This study, featuring the largest cohort so far reported in the literature, shows that PR is equally effective in the more severe COPD patients, i.e. those with CRF, and supports the prescription of PR also in these patients.
Carone
M
M
Fondazione Salvatore Maugeri, IRCCS, Department of Pulmonary Disease, Scientific Institute of Veruno, Italy. mauro.carone@fsm.it
Patessio
A
A
Ambrosino
N
N
Baiardi
P
P
Balbi
B
B
Balzano
G
G
Cuomo
V
V
Donner
C F
CF
Fracchia
C
C
Nava
S
S
Neri
M
M
Pozzi
E
E
Vitacca
M
M
Spanevello
A
A
D000368:Aged; D000704:Analysis of Variance; D001945:Breathing Exercises; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010806:Physical Education and Training; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D012132:Respiratory Muscles / Q000503:physiopathology; D016896:Treatment Outcome