Abstract
A retrospective study has recently shown that exercise tolerance and symptoms gain a significant benefit following rehabilitation in COPD patients with lung hyperinflation when compared without (Crisafulli E, et al. Intern Emerg Med 2012). We therefore conducted a prospective multicenter trial to confirm these findings.
We have enrolled 319 consecutive COPD patients (age 70±8 yrs, 77% M) admitted to a standard hospital-based rehabilitation course in 6 italian centres. Population has been divided into two distinct groups whose characteristics correspond to either parenchimal destructive (A, n=130) or airway obstructive (B, n=189) phenotype (Pistolesi M, et al. Respir Med 2008).
Groups were similar for age, sex, body mass, smoking habit and gas exchange. Age-unadjusted Charlson comorbidity score was higher in group B than in A (1.33±1.43 and 0.98±1.17, respectively p=0.031). Comparisons of pre-to-post absolute values and changes (Δ) in exercise tolerance (6MWT), Borg dyspnea (D), fatigue (F) and SatO2 nadir (N) on effort, perceived breathlessness (MRC), and quality-of-life (SGRQ) were made. Patients of both groups significantly (p<0.05) improved their 6MWT, D, F, and MRC level after rehabilitation, whereas SGRQ score improved in group A only (p<0.01). Δ-D only was different in group B than in A (-1.33±1.91 and -0.41±1.61 pt respectively, p<0.001).
This study confirms that COPD patients with or without emphysema phenotype may similarly benefit from pulmonary rehabilitation, although the former individuals are less likely to gain in perceived dyspnea on exertion.
- © 2013 ERS