title: COPD patients with severe diffusion defect in carbon monoxide diffusing capacity predict a better outcome for pulmonary rehabilitation.
abstract: OBJECTIVE
  The aim of this study was to compare the effects of pulmonary rehabilitation (PR) on six-minute walk test (6mWT) between chronic obstructive pulmonary disease (COPD) patients with moderate or severe carbon monoxide diffusion defects. We also evaluated dyspnea sensation, pulmonary functions, blood gases analysis, quality of life parameters and psychological symptoms in both groups before and after pulmonary rehabilitation.
  
  
  METHODS
  Patients with COPD underwent a comprehensive 8-week out-patient PR program participated in this study. Patients grouped according to diffusion capacity as moderate or severe. Outcome measures were exercise capacity (6mWT), dyspnea sensation, pulmonary function tests, blood gases analysis, quality of life (QoL) and psychological symptoms.
  
  
  RESULTS
  A total of 68 patients enrolled in the study. Thirty-two (47%) of them had moderate diffusion defect [TlCO; 52 (47-61)mmol/kPa] and 36 (53%) of them had severe diffusion defect [TlCO; 29 (22-34)mmol/kPa]. At the end of the program, PaO2(p=0.001), Modified Medical Research Council dyspnea scale (p=0.001), 6mWT (p<0.001) and quality of life parameters improved significantly in both groups (p<0.05). Also the improvement in DlCO(p=0.04) value and FEV1% (p=0.01) reached a statistically significant level in patients with severe diffusion defect. When comparing changes between groups, dyspnea reduced significantly in patients with severe diffusion defect (p=0.04).
  
  
  CONCLUSIONS
  Pulmonary rehabilitation improves oxygenation, severity of dyspnea, exercise capacity and quality of life independent of level of carbon monoxide diffusion capacity in patents with COPD. Furthermore pulmonary rehabilitation may improve DlCOvalues in COPD patients with severe diffusion defect.
authors.affiliation: Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Pulmonary Rehabilitation Unit, Izmir, Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Sahin
authors.affiliation: Katip Celebi University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation.
authors.forename: I
authors.initials: I
authors.lastname: Naz
authors.affiliation: Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Chest Diseases, Izmir, Turkey. Electronic address: yeldavatansever@hotmail.com.
authors.forename: Y
authors.initials: Y
authors.lastname: Varol
authors.affiliation: Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Chest Diseases, Izmir, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Aksel
authors.affiliation: Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Pulmonary Rehabilitation Unit, Izmir, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Tuksavul
authors.affiliation: Dr Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Department of Chest Diseases, Izmir, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Ozsoz
mesh_terms: D000368:Aged; D002248:Carbon Monoxide / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011653:Pulmonary Diffusing Capacity; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology* / Q000534:rehabilitation*; D012129:Respiratory Function Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D002248:Carbon Monoxide
keywords: 6-Minute walk test; DLCO; Dyspnea; Pulmonary function tests; Pulmonary rehabilitation; Quality of life