More Benefit from Rehab in Earlier Stages of COPD

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90 percent of COPD patients are
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Researchers recruited 106 patients with COPD who completed an eight-week course of PR. Each patient was evaluated at the beginning and the conclusion of the course for exercise capacity, dyspnea in daily activities, such as walking and carrying groceries, fatigue, quality of life, and other indices of health.

The researchers then compared the results of patients who died within two years of the program to those who survived longer and found that even after controlling for potentially complicating factors patients who lived longer than two years were able to obtain more positive results from their PR program than those who had end-stage COPD.

“Although people who died within two years after entering a pulmonary rehabilitation program improved their exercise capacity during the program, they improved less on this and other key variables than did those who lived longer,” said Bonnie Steele, A.R.N.P., Ph.D., a respiratory clinical nurse specialist at the VA Puget Sound Health Care System in Seattle. “Previous work has taught us that even with severe obstructive lung disease based upon pulmonary function, people can derive significant benefits from PR,” said Steele, “but our limited findings suggest that other, presently unappreciated factors present at end of life may contribute to poorer outcomes in end-stage patients with respect to exercise capacity and quality of life.”

There are several possible explanations for the findings, including the possibility that patients in end-stage disease have overall poorer muscle function and greater levels of deconditioning and the possible specific impact of selected co-morbidities, such as heart failure. “Our sample was too small to explicate this fully,” said Steele, “but it suggests that treatments for end-stage patients with COPD may still be effective and introducing exercise training sooner in the course of their disease results in more improvement.”

MEDICA.de; Source: American Thoracic Society