title: Impact of pulmonary rehabilitation in subjects with mild COPD.
abstract: BACKGROUND
  Pulmonary rehabilitation (PR) is a core component of the management of patients with moderate-to-very-severe COPD. However, as impairments in quadriceps muscle strength and health-related quality of life (HRQOL) are already present in patients with mild COPD, there is a need to investigate whether PR could also be beneficial to these patients. Thus, this study assessed the impact of PR on patients with mild COPD.
  
  
  METHODS
  A quasi-experimental study was conducted. Twenty-six participants (67.8 ± 10.3 years old; FEV1 83.8 ± 6.4% of predicted) enrolled in a 12-week PR program with exercise training and psychoeducation. Lung function was assessed by spirometry, dyspnea with the Modified Medical Research Council questionnaire, functional balance with the Timed Up and Go test, muscle strength with 10-repetition maximum testing, exercise tolerance with the 6-min walk test, emotional state with the Depression Anxiety Stress Scales, and HRQOL with the St George Respiratory Questionnaire (SGRQ).
  
  
  RESULTS
  Significant effects were observed on participants' dyspnea (P = .003, effect size [ES] = 0.7), functional balance (P < .001, ES = 0.8), shoulder flexor/knee extensor strength (P < .001, ES = 1.2-1.3), and exercise tolerance (P < .001, ES = 0.5). With the exception of the SGRQ impact score, the symptom (P < .001, ES = 0.6), activity (P = .02, ES = 0.4), and total (P = .005, ES = 0.3) scores improved significantly after PR. The PR program had no significant effect on participants' lung function and emotional state.
  
  
  CONCLUSIONS
  Patients with mild COPD benefit from PR and could therefore be routinely included in these programs. Studies with more robust designs and with long-term follow-ups are needed to inform guidelines for PR in mild COPD.
authors.affiliation: School of Health Sciences, University of Aveiro, Aveiro, Portugal. Research Centre in Physical Activity, Health and Leisure, Faculty of Sports, University of Porto, Porto, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Jácome
authors.affiliation: School of Health Sciences, University of Aveiro, Aveiro, Portugal. Unidade de Investigação e Formação sobre Adultos e Idosos, Porto, Portugal. amarques@ua.pt.
authors.forename: Alda
authors.initials: A
authors.lastname: Marques
mesh_terms: D000368:Aged; D001007:Anxiety / Q000175:diagnosis; D003863:Depression / Q000175:diagnosis; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D053580:Muscle Strength / Q000502:physiology; D004856:Postural Balance / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D012129:Respiratory Function Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: COPD; chronic obstructive pulmonary disease; early medical intervention; pulmonary rehabilitation