title: Respiratory rehabilitation in healing depression and anxiety in COPD patients.
abstract: Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory affection of the whole lung, characterized by an accelerated loss of the pulmonary functions, that reduces the patients' independence and stops them from having a normal, active life. The medical rehabilitation is considered "Third class rehabilitation", after preventive medicine and pharmaceutical medicine, and the respiratory rehabilitation recovery represents a complex structure of service addressing to patients with chronic pulmonary illnesses whose aim is to optimize the physical performances, psycho-social and autonomy.
  
  
  OBJECTIVE
  The main objective of this study is to show the importance of respiratory rehabilitation that is correctly and timely made, based on the gravity and stage of the illness, the COPD patient's associated illnesses and their importance in improving the patient's mental and physical quality of life. Patients from the study were assigned a complex pulmonary rehabilitation regimen consisting of 10 physical exercise sessions and 10 educational sessions, for two weeks, followed by 3 physical education sessions and medical education per week, for six weeks. MATERIAL AND METHOD; The research included 35 COPD patients from the 5th medical Geriatric and Gerontology. Clinic during 1.03.2014-30.11.2014. Patients from the study were assigned a complex pulmonary rehabilitation regimen consisting of 10 physical exercise sessions and 10 educational session for two weeks, followed by 3 sessions a week for 6 weeks. The dyspnea evaluation was made by BORG and MRC dyspnea scales, the quality of life was measured by St. George and CAT questionnaires, and anxiety and anxiety and depression were quantified by Hamilton Anxiety Rating Scale (HARS) and Hamilton Depression Rating Scale (HDRS).
  
  
  RESULTS
  The gradation of dyspnea on BORG scale was correlated with the variation of the expiratory capacity that varied at COPD patients, suggesting that hyperinflation has a major role in producing the dyspnea. The average score measurement was about 75.25 ± 5.9. the positive effects of rehab were validated by decreasing the St. George score by 16% to the initial value. Respiratory rehab was an important way of treatment due to effort tolerance increasing and the patient's independence. Depression was significantly more pronounced in women (Z = -1.876: p = 0.039). The little value of maximum respiratory volume per second (VEMS) was correlated to a bigger HARS and HDRS score.
  
  
  CONCLUSIONS
  The prevalence and importance of symptoms of anxiety and depression in COPD patients requires a specific questionnaire as routine screening procedure, for detecting early symptoms and preventing their progress.
authors.forename: Maria-Mădălina
authors.initials: MM
authors.lastname: Bodescu
authors.forename: Adina Magdalena
authors.initials: AM
authors.lastname: Turcanu
authors.forename: Maria-Cristina
authors.initials: MC
authors.lastname: Gavrilescu
authors.forename: T
authors.initials: T
authors.lastname: Mihăescu
mesh_terms: D000328:Adult; D000368:Aged; D000375:Aging; D001007:Anxiety / Q000209:etiology* / Q000534:rehabilitation; D003863:Depression / Q000209:etiology* / Q000534:rehabilitation; D005260:Female; D005853:Geriatrics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010353:Patient Education as Topic / Q000379:methods; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000534:rehabilitation*; D011788:Quality of Life; D012189:Retrospective Studies; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D016896:Treatment Outcome