title: The effect of pulmonary rehabilitation on COPD exacerbation frequency per year.
abstract: OBJECTIVE
  We aimed to investigate the effect of pulmonary rehabilitation (PR) on the number of exacerbations in chronic obstructive pulmonary diseases (COPD) patients.
  
  
  METHODS
  The study included 82 patients referred to our hospital's PR Unit between June 2013 and June 2014. Patients were divided into two groups, including those with low exacerbation risk (low number of exacerbations) (Groups A + B) and those experiencing frequent exacerbations (Groups C+ D) according to the combined COPD assessment.
  
  
  RESULTS
  Patients were included in a PR program that consisted of 16 sessions in total, held twice a week over a period of 2 months. After one year, patients were called to find out about their COPD exacerbation frequency. Groups presented similar characteristics in terms of age, BMI and smoking duration prior to the PR program (P > .05). The frequent exacerbators had lower scores in exercise capacity, arterial oxygenation, health-related quality of life and anxiety (P < .05). However, both groups exhibited significantly improved scores in the perceived dyspnea, FEV1 percentage, arterial oxygenation, exercise capacity, quality of life and anxiety after pulmonary rehabilitation (P < .05). The number of post-PR emergency referrals and hospitalization (P < .0001, P = .04), and depression score decreased significantly among the frequent exacerbators. Group 1 presented insignificant changes in the number of emergency referrals and hospitalizations (P < .05).
  
  
  CONCLUSIONS
  Notwithstanding disease severity, PR treatment is reported to have positive effects on COPD patients in terms of perceived dyspnea, exercise capacity, arterial oxygenation, quality of life, anxiety and depression. This study found reduced number of emergency referrals and hospitalization among COPD patients with frequent exacerbations after PR.
authors.affiliation: Department of Pulmonary Rehabilitation, Pulmonary Rehabilitation Unit, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Hulya
authors.initials: H
authors.lastname: Sahin
authors.affiliation: Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Yelda
authors.initials: Y
authors.lastname: Varol
authors.affiliation: Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Katip Celebi University, Izmir, Turkey.
authors.forename: Ilknur
authors.initials: I
authors.lastname: Naz
authors.affiliation: Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Nimet
authors.initials: N
authors.lastname: Aksel
authors.affiliation: Department of Pulmonary Rehabilitation, Pulmonary Rehabilitation Unit, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Fevziye
authors.initials: F
authors.lastname: Tuksavul
authors.affiliation: Department of Chest Diseases, Dr. Suat Seren Chest Diseases and Thoracic Surgery Training and Research Hospital, Izmir, Turkey.
authors.forename: Ayse
authors.initials: A
authors.lastname: Ozsoz
mesh_terms: D000368:Aged; D018450:Disease Progression; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000639:trends; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D012008:Recurrence; D012129:Respiratory Function Tests; D014421:Turkey / Q000453:epidemiology
keywords: COPD; combined assessment; exacerbation; pulmonary rehabilitation