Are patients with COPD more active after pulmonary rehabilitation?

Chest. 2008 Aug;134(2):273-80. Pitta F, Troosters T, Probst VS, Langer D, Decramer M, Gosselink R. Respiratory Rehabilitation and Respiratory Division, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium.

BACKGROUND: Despite a variety of benefits brought by pulmonary rehabilitation to patients with COPD, it is unclear whether these patients are more active during daily life after the program.

METHODS: Physical activities in daily life (activity monitoring), pulmonary function (spirometry), exercise capacity (incremental cycle-ergometer testing and 6-min walk distance testing), muscle force (quadriceps and handgrip force, and inspiratory and expiratory maximal pressures), quality of life (chronic respiratory disease questionnaire), and functional status (pulmonary functional status and dyspnea questionnaire-modified version) were assessed at baseline, after 3 months of a multidisciplinary rehabilitation program, and at the end of a 6-month multidisciplinary rehabilitation program in 29 patients (mean [+/- SD] age, 67 +/- 8 years; FEV(1), 46 +/- 16% predicted).

RESULTS: Exercise capacity, muscle force, quality of life, and functional status improved significantly after 3 months of pulmonary rehabilitation (all p < 0.05), with further improvements in muscle force, functional status, and quality of life at 6 months. Movement intensity during walking improved significantly after 3 months (p = 0.046) with further improvements after 6 months (p = 0.0002). Walking time in daily life did not improve significantly at 3 months (mean improvement, 7 +/- 35%; p = 0.21), but only after 6 months (mean improvement, 20 +/- 36%; p = 0.008). No significant changes occurred in other activities or in the pattern of the time spent walking in daily life. Changes in dyspnea after the program were significantly related to changes in walking time in daily life (r = 0.43; p = 0.02).

CONCLUSION: If one aims at changing physical activity habits in the daily life of COPD patients, the contribution of long-lasting programs might be important.




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