Pulmonary rehabilitation makes difference in COPD patients

A pulmonary rehabilitation (PR) programme for chronic obstructive pulmonary disease (COPD) yields sustained improvements in anxiety and quality of life of patients over 2 years, a study has shown. However, the positive changes in dyspnoea, depression, and stress symptoms may only last short term.

The study population comprised 165 COPD patients (mean age, 72 years; 55 percent male) who completed an 8-week, community-based, comprehensive PR programme. This intervention involved 2-hour sessions held twice weekly. During sessions, patients performed aerobic exercise and attended an educational programme. Patients were also encouraged to perform daily walking exercise up to 30 minutes at home.

At week 8 weeks, the patients showed significant improvements in several parameters. These included  dyspnoea (measured using the modified Medical Research Council questionnaire), quality of life (assessed using Saint George’s Respiratory Questionnaire), exercise capacity (measured with the Incremental Shuttle Walk Test), anxiety (evaluated using the Anxiety Inventory for Respiratory Disease), and the Depression Anxiety Stress Scale (p<0.001 for all).

Without a maintenance programme, changes seen at 8 weeks persisted for only anxiety symptoms and quality of life over the 2-year follow-up.

On multivariable analysis, initial elevated levels of dyspnoea, depression, and anxiety and decreased exercise capacity significantly predicted sustained improvement in quality of life (p<0.001 for all).

Additional studies comparing a well-designed maintenance programme with no maintenance following PR are warranted to determine whether maintenance programmes can widen the range and magnitude of beneficial outcomes over the long term.