title: Maintaining Gains Following Pulmonary Rehabilitation.
abstract: OBJECTIVE
  Pulmonary rehabilitation (PR) is an accepted intervention for individuals with chronic obstructive pulmonary disease. Despite initial improvements following PR, many patients eventually return to baseline function or decline even further. The aim of this study is to look at long-term (>1 year) outcomes following PR.
  
  
  METHODS
  This was a prospective cohort study of patients who had completed PR. Participants were invited for an assessment consisting of participant interviews and clinical assessments using standardised instruments.
  
  
  RESULTS
  129 patients between 2003 and 2012 completed rehabilitation and were eligible. 88 patients were included in the analysis. The mean time of the long-term assessment was 22 months following PR. The mean age was 71 years. Mean FEV1 was 46%. There was a statistically significant (p < 0.001) increase in the incremental shuttle walk test distance of 29.0 m following PR but this gain was lost at the long-term reassessment. Chronic Respiratory Questionnaire (CRQ) scores showed a statistically significant (p < 0.001) increase in all four domains but only the domains of dyspnoea and fatigue remained statistically significant (p < 0.001, p < 0.01, respectively) at the long-term reassessment. Hospital Anxiety and Depression Scale scores reduced following rehabilitation but only the anxiety component was statistically significant (p < 0.01). These improvements persisted at the long-term reassessment but were not statically significant.
  
  
  CONCLUSIONS
  This study confirms that many of the functional gains achieved in PR are lost in the longer term. Regular surveillance or monitoring of these patients post-PR is important to identify those requiring further intervention.
authors.affiliation: Royal Melbourne Hospital - Royal Park Campus, 34 Poplar Road, Parkville, VIC, 3052, Australia. edwin.luk@mh.org.au.
authors.forename: Edwin K
authors.initials: EK
authors.lastname: Luk
authors.affiliation: Royal Melbourne Hospital - Royal Park Campus, 34 Poplar Road, Parkville, VIC, 3052, Australia.
authors.forename: Fary
authors.initials: F
authors.lastname: Khan
authors.affiliation: Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia.
authors.forename: Louis
authors.initials: L
authors.lastname: Irving
mesh_terms: D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000534:rehabilitation; D003863:Depression / Q000209:etiology / Q000534:rehabilitation; D004417:Dyspnea / Q000209:etiology / Q000534:rehabilitation; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000502:physiology; D005221:Fatigue / Q000209:etiology / Q000534:rehabilitation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
keywords: Chronic obstructive; Exercise; Pulmonary disease; Pulmonary rehabilitation