Efficacy of pulmonary rehabilitation in chronic respiratory failure (CRF) due to chronic obstructive pulmonary disease (COPD): The Maugeri Study

• Published in: Respiratory medicine 2007-12, Vol.101 (12), p.2447-2453
• Main Authors: Carone, M, Patessio, A, Ambrosino, N, Baiardi, P, Balbi, B, Balzano, G, Cuomo, V, Donner, C.F, Fracchia, C, Nava, S, Neri, M, Pozzi, E, Vitacca, M, Spanevello, A
• Format: Article
• Language: English
• Subjects: Aged; Analysis of Variance; Biological and medical sciences; Body mass index; Breathing Exercises; Carbon dioxide; Chronic obstructive pulmonary disease; Chronic obstructive pulmonary disease, asthma; Chronic respiratory failure; Councils; Disease; Emphysema; Exercise Therapy - methods; Exercise Tolerance; Female; Forced Expiratory Volume; Health Status Indicators; Heart attacks; Humans; Lungs; Male; Medical sciences; Middle Aged; Miscellaneous; Mortality; Oxygen therapy; Physical Education and Training; Pneumology; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - rehabilitation; Pulmonary rehabilitation; Pulmonary/Respiratory; Quality of Life; Questionnaires; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Respiratory Insufficiency - etiology; Respiratory Insufficiency - physiopathology; Respiratory Insufficiency - rehabilitation; Respiratory Muscles - physiopathology; Respiratory system : syndromes and miscellaneous diseases; Treatment Outcome; Walking
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2007.07.016

Summary While the effectiveness of pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) is well established, its effectiveness in the most severe category of COPD, i.e. patients with chronic respiratory failure (CRF), is less well known. Objective To verify the effects of PR in patients with CRF, and compare the level of improvement with PR in these patients to that of COPDs not affected by CRF. Methods A multi-centre study was carried out on COPD patients with versus without CRF. The PR program included educational support, exercise training, and nutritional and psychological counselling. Lung function, arterial gases, walk test (6MWT), dyspnoea (MRC; BDI/TDI), and quality of life (MRF28 ; SGRQ) were evaluated. Results Thousand forty seven consecutive COPD inpatients (327 with CRF) were evaluated. In patients with CRF all parameters improved after PR (0.001). Mean changes: FEV1 , 112 ml; P aO2 , 3.0 mmHg; P aCO2 , 3.3 mmHg; 6MWT, 48 m; MRC, 0.85 units; MRF28 total score, 11.5 units. These changes were similar to those observed in patients without CRF. Conclusions This study, featuring the largest cohort so far reported in the literature, shows that PR is equally effective in the more severe COPD patients, i.e. those with CRF, and supports the prescription of PR also in these patients.