Three years of pulmonary rehabilitation: inhibit the decline in airflow obstruction, improves exercise endurance time, and body-mass index, in chronic obstructive pulmonary disease.
BACKGROUND
Pulmonary rehabilitation is known to be a beneficial treatment for COPD patients. To date, however, there is no agreement for how long a rehabilitation program should be implemented. In addition, current views are that pulmonary rehabilitation does not improve FEV1 or even slow its decline in COPD patients. The aim of the study was to examine the efficacy of a 3 year outpatient pulmonary rehabilitation (PR) program for COPD patients on pulmonary function, exercise capability, and body mass index (BMI).


METHODS
A matched controlled trial was performed with outcome assessments evaluated at 6, 12, 18, 24, 30, and 36 months. Eighty patients with moderate to severe COPD (age 63 +/- 7 years; FEV1 48% +/- 14) were recruited. The control group received standard care only, while in addition, the case study group received PR for duration of three years. These groups were matched for age, sex, BMI, FEV1% and number of pack-years smoked.


RESULTS
The decline in FEV1 after the three years was significantly lower in the PR group compared to control, 74 ml versus 149 ml, respectively (p < 0.001). Maximal sustained work and endurance time improved after a short period of PR and was maintained throughout the study, in contrast to the control group (p < 0.01). A decreased BMI was noted in the control group after three years, while in the PR group a mild improvement was seen (p < 0.05).


CONCLUSIONS
Three years of outpatient pulmonary rehabilitation resulted in modifying the disease progression of COPD, as well as improving physical performance in these patients.
Stav
David
D
Pulmonary Institute, Tel Aviv University, Assaf Harofeh Medical Center, Zerrifin, Israel. dstav@asaf.health.gov.il
Raz
Meir
M
Shpirer
Isaac
I
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D000368:Aged; D000402:Airway Obstruction / Q000188:drug therapy / Q000534:rehabilitation; D015992:Body Mass Index; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005080:Exercise Test; D005081:Exercise Therapy; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000534:rehabilitation*; D012907:Smoking
D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists