Effects of pulmonary rehabilitation on exercise capacity in patients with COPD: a number needed to treat study.
BACKGROUND
Pulmonary rehabilitation (PR) is recognized as an evidence-based treatment in improving dyspnea and quality of life in patients with COPD. We evaluated the number needed to treat (NNT) to achieve an increase in physical capacity, as defined by a significant improvement in the six-minute walk test (6MWT) in patients with COPD undergoing PR.


METHODS
The study enrolled 284 patients aged 41 to 86 years (mean age 69.4 years) divided into two groups: a study group (222 patients) undergoing a PR program, and a control group (62 patients) treated only with drugs. The study group included patients with COPD divided in four subgroups according to GOLD stages.


RESULTS
In the study group, 142 out of 222 patients (64%) had an increase of at least 54 m in the 6MWT following PR versus 8 out of 62 patients (13%) in the control group after the same time interval. The NNT in the overall study group was 2; the same NNT was obtained in GOLD stages 2, 3, and 4, but was 8 in stage 1.


CONCLUSIONS
PR is highly effective in improving the exercise capacity of patients with COPD, as demonstrated by a valuable NNT, with better results in patients with a more severe disease.
Riario-Sforza
Gian Galeazzo
GG
Pulmonary rehabilitation, Istituti Clinici di Perfezionamento, Milan, Italy.
Incorvaia
Cristoforo
C
Paterniti
Fulvia
F
Pessina
Laura
L
Caligiuri
Roberta
R
Pravettoni
Chiara
C
Di Marco
Fabiano
F
Centanni
Stefano
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001945:Breathing Exercises; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D020127:Recovery of Function; D012132:Respiratory Muscles / Q000503:physiopathology*; D018401:Sample Size; D012720:Severity of Illness Index; D016896:Treatment Outcome; D016138:Walking