Duration of pulmonary rehabilitation to achieve a plateau in quality of life and walk test in COPD.
OBJECTIVE
To address the minimum duration of pulmonary rehabilitation necessary for patients with chronic obstructive pulmonary disease (COPD) to achieve a plateau in Health-Related Quality of Life (HRQL) and exercise tolerance.


METHODS
COPD patients with a dyspnea rating of at least 2 on the Medical Research Council scale participated in an outpatient rehabilitation program of 3 weekly sessions for 12 weeks. Measurements included HRQL and exercise tolerance 2 weeks before the program started and every 2 weeks thereafter. Patients were considered to have reached a plateau if they showed no improvement beyond 20% of the minimal important difference between 2 consecutive evaluations on HRQL score or walk tests.


RESULTS
Twenty-eight patients participated. The number of patients achieving stability after 8 weeks, showing continued improvement after 8 weeks, and demonstrating an erratic pattern of change was as follows: for physical function 16 (56%), 10 (37%) and 2 (7%) patients; for emotional function 22 (79%), 5 (18%) and 1 (4%); and for 6-min walk test 21 (75%), 5 (18%) and 2 (7%). More severe patients demonstrated a greater likelihood (76%) of achieving stability in physical function at 12 weeks than did less severe patients (27%; p on difference=0.003). The likelihood of stability at 12 weeks in emotional function and the 6-min walk test did not differ by severity.


CONCLUSIONS
A program of 3 weekly 3-h sessions of outpatient pulmonary rehabilitation program should last at least 8 weeks in order to achieve optimal HRQL and exercise tolerance for most patients.
Solanes
Ingrid
I
Department of Pneumology, Hospital de la Santa Creu i de Sant Pau, Facultad de Medicina, UAB, Barcelona 08032, Spain. isolanes@santpau.cat
Güell
Rosa
R
Casan
Pere
P
Sotomayor
Coloma
C
Gonzalez
Araceli
A
Feixas
Teresa
T
Gonzalez
Mercedes
M
Guyatt
Gordon
G
D000328:Adult; D000368:Aged; D004417:Dyspnea / Q000209:etiology / Q000534:rehabilitation*; D005080:Exercise Test / Q000379:methods; D017079:Exercise Tolerance; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000534:rehabilitation*; D011788:Quality of Life