How effective is a community based pulmonary rehabilitation programme for patients with mild to moderate chronic obstructive pulmonary disease?

2017 ◽  
Author(s):  
Sarah Hicks
2019 ◽  
Vol 32 (2) ◽  
pp. 108-117
Author(s):  
Cherry WL Lau ◽  
Thomas Mok ◽  
William WN Ko ◽  
Bobby HP Ng ◽  
Irene HL Chan ◽  
...  

Background and objective Pulmonary rehabilitation programme (PRP) is an important component in the management of chronic obstructive pulmonary disease (COPD). However, to date so far there has been limited literature on the survival outcomes of patients with COPD after a PRP in Hong Kong. This study aimed to investigate the outcomes of a pulmonary rehabilitation programme on the survival rates of a retrospective cohort of patients with COPD. Methods This was a retrospective study that included subjects who participated in the PRP in a rehabilitation hospital from the year 2003 to 2015. A total of 431 patients with chronic obstructive pulmonary disease were identified from the electronic record system of the hospital. The dataset were split into two age groups for reporting and analysis using the mean age of 72 as the cut-off. Their median survival times were calculated using Kaplan–Meier analysis. Cox-proportional regression model was used to explore factors that predicted better survival. The most significant predictors were used as strata, and their respective effects on survival functions were analysed with Kaplan–Meier analysis again. Results The overall median survival of the cohort was 4.3 years. The median survival times of the younger patient group (aged <72) and the older patient group (aged ≥72) were 5.3 and 3.6 years, respectively. For the patients, aged <72 years old, Moser’s Activities of Daily Living class and the pulmonary rehabilitation programme completion rate were the most significant survival predictors. For the patients aged ≥72 years old, Monitored Functional Task Evaluation score was the most significant survival predictor. Conclusion Moser’s Activities of Daily Living class ≥2 and non-completion of PRP for younger group, low exercise capacity with Monitored Functional Task Evaluation score <17 for older group were identified as significant predictors of poor survival. The findings of this study helped identifying those patients with COPD who have the needs to be more intensively treated and closely monitored.


2019 ◽  
Vol 26 (3) ◽  
pp. 63-70
Author(s):  
Evgeny S. Ovsyannikov ◽  
Andrey V. Budnevsky ◽  
Yanina S. Shkatova

Aim. To evaluate the effectiveness of pulmonary rehabilitation programme in patients with chronic obstructive pulmonary disease (COPD) and obesity. Materials and methods. The study included two groups of patients. The first group consisted of 44 patients with COPD and obesity (23 men and 21 women; median age — 57.47±0.76 years; average body mass index (BMI) — 34.1±1.24 kg/m2) who were receiving only standard medical treatment for COPD. The second group consisted of 44 patients (22 men, 22 women; median age — 56.07±0.83 years, average BMI — 33.4±1.62 kg/m2) who were undergoing pulmonary rehabilitation along with the standard medical treatment for COPD. Pulmonary rehabilitation programme involved group training of COPD patients including dietary recommendations, graduated exercise, as well as recommendations on smoking cessation. At the initial stage and 12 months after the study, the severity of COPD symptoms was assessed using a visual analogue scale, the frequency of exacerbations and hospitalisations, spirometry parameters, as well as quality of life data obtained via the SF-36 questionnaire. Results. At 12 months into the study, patients from the second group showed a significant decrease in the number of COPD exacerbations and related hospitalisations; a decrease in the shortness of breath, cough, sputum production; as well as an improvement of the SF-36 questionnaire with respect to a number of points. At the same time, spirometry parameters did not improve significantly. Conclusion. Inclusion of pulmonary rehabilitation programmes in the standard treatment of patients with COPD and obesity contributes to providing higher effcacy of medical treatment, decreasing the load of main COPD clinical symptoms, as well as to reducing their impact on the patients’ health status and improving life quality.


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