Improvements in outcomes for chronic obstructive pulmonary disease (COPD) attributable to a hospital-based respiratory rehabilitation programme

• Published in: Australian and New Zealand Journal of Medicine 1999-02, Vol.29 (1), p.59-65
• Main Authors: Young, P., Dewse, M., Fergusson, W., Kolbe, J.
• Format: Article
• Language: English
• Subjects: Analysis of Variance; Biological and medical sciences; Chronic obstructive pulmonary disease (COPD); Chronic obstructive pulmonary disease, asthma; Dyspnea; exercise; Exercise Therapy; Exercise Tolerance; Female; Health Education; Humans; Lung Diseases, Obstructive - rehabilitation; Male; Medical sciences; Middle Aged; Outpatient Clinics, Hospital; Pneumology; Prospective Studies; rehabilitation; Respiratory Function Tests; Tropical medicine
• ISSN: 0004-8291; 1445-5994
• DOI: 10.1111/j.1445-5994.1999.tb01589.x

Aim: To determine whether the benefits of pulmonary rehabilitation, demonstrated in selected subjects in randomised controlled studies, can be achieved by a hospital‐based respiratory rehabilitation programme conducted as part of routine clinical management. Methods: Design: A prospective longitudinal study of patients with severe chronic obstructive pulmonary disease (COPD) enrolled in a hospital based, non‐medically supervised, outpatient, respiratory rehabilitation programme was undertaken. The rehabilitation programme was of pragmatic design and content, supervised by respiratory physiotherapists and comprised seven two hour sessions over one month for groups of six to eight patients. It included education on disease management, practical instruction in coping skills, as well as a progressive aerobic exercise programme for specific muscle training related to functional activities. Subjects were assessed prior to the programme but after optimisation of pharmacologic therapy, at the completion of the programme and at three months and six months post‐programme. Principal outcome parameters were exercise capacity (as assessed by a six minute walk distance [MWD] test), degree of perceived breathlessness and quality of life (QOL) (assessed by the Chronic Respiratory Disease Questionnaire [CRDQ]). Results: Fifty‐one subjects with severe COPD (Fev1=0.9±0.4 1) completed the programme. There was a significant improvement in exercise capacity (a six MWD test improved from 375±126 m at baseline to 440±109 m at three months, p