Short-term pulmonary rehabilitation programs benefit COPD patients

Last Updated: 2001-07-13 13:48:48 EDT (Reuters Health)
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WESTPORT, CT (Reuters Health) – Short-term outpatient pulmonary rehabilitation programs appear to benefit patients with COPD, according to two reports in the June issue of Chest.

Dr. James Patrick Finnerty and colleagues from the Countess of Chester Hospital in the UK randomly assigned 65 COPD patients to a 6-week program of education and exercise or to treatment with the usual outpatient protocol. At 12 and 24 weeks, the researchers administered the St. George's Respiratory Questionnaire (SGRQ) to each subject.

Among patients who received the education and exercise program, the SGRQ was 59.9 at baseline, 47.4 at 12 weeks and 50.6 at 24 weeks. The corresponding SGRO in the control group, which had a baseline SGRQ of 59.3, "did not change significantly over 24 weeks," according to the study's findings.

At 12 weeks, the researchers note, there was a 10.4 point difference between the groups and an 8.1 point difference at 24 weeks–which favored those in the education and exercise group. The researchers also found "an increase in exercise tolerance maintained for at least 3 months" in the active treatment group.

In the second report, Dr. Nicolino Ambrosino and colleagues from the Instituto Scientifico di Gussago in Italy studied the benefit of long-term pulmonary rehabilitation in 61 patients with chronic airway obstruction who underwent an initial 8-week outpatient pulmonary rehabilitation program.

The researchers randomly selected approximately half of the patients to undergo a second pulmonary rehabilitation program, and after 1 year both groups participated in a third pulmonary rehabilitation program.

Patients in the second pulmonary rehabilitation program showed improvements in exercise tolerance, dyspnea and health-related quality of life. However, after 1 year, there was no difference between the two groups in exercise tolerance or dyspnea. Only health-related quality of life was better in both groups 2 years after their first pulmonary rehabilitation program, the researchers report.

Yearly hospitalizations and exacerbations significantly decreased in both groups 2 years after the initial pulmonary rehabilitation program, compared with the 2 years before the program. However, among the patients who participated in the second pulmonary rehabilitation program, yearly exacerbations were further reduced compared with those who did not participate in the second program.

Dr. Ambrosino's group also found that the third pulmonary rehabilitation program improved exercise tolerance in both patient groups.

Given their findings, the researchers suggest that "successive, yearly interventions lead to similar short-term gains but do not result in additive long-term physiologic benefits."

"Whether or not these limited benefits make it worthwhile to perform yearly repetitions of the pulmonary rehabilitation program in a generalized way must be carefully evaluated on the basis of cost/benefit ratios considerations."

Chest 2001;119:1696-1710.

-Westport Newsroom 203 319 2700

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