scholarly journals Effectiveness of pulmonary rehabilitation in improving quality of life in patients with different COPD stages

2020 ◽  
pp. 03-08
Author(s):  
Adrian Cosmin ILIE ◽  
Alexandru CRIŞAN ◽  
Patricia HOGEA STANCA ◽  
Daniel TRĂILĂ

Introduction. Anxiety and depression are frequently associated conditions in COPD patients, and have also significant impact on their quality of life (QoL) and on the course of the disease. Pulmonary rehabilitation (PR) is an adjuvant, non-pharmacological method used in symptomatic COPD patients. The study aimed to evaluate the impact of COPD on QoL depending on disease severity, and to assess the supposedly positive effects of a pulmonary rehabilitation program (PRP) for COPD patients. Material and method. This research included patients with COPD GOLD stages II-IV undergoing bronchodilator therapy. QoL was assessed with the self-administered St George's Respiratory Questionnaire (SGRQ), and depression with the Beck Depression Inventory (BDI). PRP included 3-5 weekly physical training sessions for an average period of 12 weeks, but not less than 3 weeks. Results. The degree of QoL impairment was moderate in stage II (41.07) and severe in stages III (70.28) and IV (81.02). The most severe depression (score 26.6 vs 2.5 in healthy subjects) was also recorded in this group. After the patients underwent all PRP, QoL reassessment at 6 months revealed statistically significant improvements in all 3 groups (p <0.05). In the GOLD COPD stage II group the average reduction was -4.38 units, in the group GOLD COPD stage III -5.37 units, and in the GOLD COPD stage IV -6.75 units. The depression score correlated with the SGRQ score, both of them being higher in the severe stages of disease. BDI administered again 6 months after PRP revealed a significant improvement in average score in all groups, respectively a decrease of -2.17 units in the COPD II group, -2.03 units in the COPD III group and -1.88 units in group COPD IV B group. Conclusion. The results of this study demonstrate a favorable impact of PRP on improving COPD associated symptoms, depression, and QoL in all the 3 monitored COPD patient groups, with statistically significant and persistent positive results over time (6 months after completion of PRP). Key words: COPD, pulmonary rehabilitation program, Quality of life (QoL), depression,

2015 ◽  
Vol 4 (2) ◽  
pp. 126-130
Author(s):  
Latinka Basara ◽  
T Jalucic Gluncic ◽  
O Maletic ◽  
D Pelicaric ◽  
S Popovic Grle ◽  
...  

Background. Holistic scope in treating persons with chronic respiratory diseases is one of the main features of pulmonary rehabilitation program (PRP) at Zagreb University. Interventions are provided by a team made of physicians and other health care professionals - physiotherapists, respiratory therapists, nurses, psychologists, occupational therapists, social workers, behavioral specialists, among others. The program itself is tailored to attend to each person's specific needs through careful interdisciplinary examination and treatment planning, establishing commom ground to address disease severity, respiratory symptoms, comorbidities, psychological manifestations and specific limitations a person has in everyday activities. The focus of PRP is the whole person rather than just a person's disease.Aim. To show the impact of PRP's person-centered approach on patient's quality of life (QoL), anxiety, depression and stress levels.Method. Questionnaires designed to measure quality of life (single question scale), anxiety, depression and stress (DASS21) were administred to 54 patients at the beginning and at the end of a three-week pulmonary rehabilitation program. Each patient underwent an individualized program of education, respiratory exercises, nutrition consultation, and psychosocial/behavioral support and intervention.Results. Results showed significant improvement in all measured parameters – higher overall QoL (p<0.01), and lowered anxiety (p< 0.01), depression (p<0.01) and stress levels (p< 0.01).Conclusions. Pulmonary rehabilitation with a person-centered approach as one of its main features appears to improve quality of life and reduce levels of anxiety, depression and stress in persons with chronic respiratory diseases.  


2008 ◽  
Vol 15 (3) ◽  
Author(s):  
Ivana Mara Oliveira Rezende ◽  
Ana Luisa Dália Moura ◽  
Bibiana Carolina Costa ◽  
Juliana Machado de Faria ◽  
Crisciane Almeida ◽  
...  

2019 ◽  
Vol 15 (1) ◽  
pp. 32-38 ◽  
Author(s):  
Jhonatan Betancourt-Peña ◽  
Vicente Benavides-Córdoba ◽  
Juan Carlos Avila-Valencia ◽  
Hamilton Elias Rosero-Carvajal

Background: The modified Medical Research Council scale (mMRC) is a standardized measure of the effect of dyspnea on the activities of the daily life of patients suffering from Chronic Obstructive Pulmonary Disease (COPD). The aim of this study was to determine the differences in the quality of life, tolerance to effort and symptoms among patients with COPD with lower (mMRC 0-1) and greater symptoms (mMRC ≥2). Methods: Cross-sectional study that included patients admitted to a pulmonary rehabilitation program and who were classified into 2 groups: a group containing the less symptomatic patients and another group with the more symptomatic ones. We collected these patients’ sociodemographic, clinical, anthropometric, anxiety, depression and quality of life (SGRQ) data. Likewise, the subjects performed the 6-minute walk test (6MWT). Finally, we measured the multidimensional BODE index score. Results: 130 subjects were included, 35 presenting an mMRC of 0 to1 and 95 having an mMRC ≥ 2, with an age of 70.87 ± 9.45 years old. The 6MWT distance, the VO2e, the total score of SGRQ, and its domains of activities and impact showed significant differences between the groups (p <0.05). Significant correlations were found in the group presenting an mMRC of 0-1 between the mMRC and the FEV1 (p = 0.028), and in the group with an mMRC ≥2 for the FVC (p = 0.031), the 6MWT distance (p = 0.000), the VO2e (p = 0.010) and the BODE index (p = 0.000). Conclusion: Patients with an mMRC of 0 to1 had better results in the 6MWT, the VO2e and the SGRQ in comparison with the most symptomatic ones.


2013 ◽  
Vol 39 (3) ◽  
pp. 349-356 ◽  
Author(s):  
Juliessa Florian ◽  
Adalberto Rubin ◽  
Rita Mattiello ◽  
Fabricio Farias da Fontoura ◽  
Jose de Jesus Peixoto Camargo ◽  
...  

OBJECTIVE: To investigate the impact of a pulmonary rehabilitation program on the functional capacity and on the quality of life of patients on waiting lists for lung transplantation. METHODS: Patients on lung transplant waiting lists were referred to a pulmonary rehabilitation program consisting of 36 sessions. Before and after the program, participating patients were evaluated with the six-minute walk test and the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). The pulmonary rehabilitation program involved muscle strengthening exercises, aerobic training, clinical evaluation, psychiatric evaluation, nutritional counseling, social assistance, and educational lectures. RESULTS: Of the 112 patients initially referred to the program, 58 completed it. The mean age of the participants was 46 ± 14 years, and females accounted for 52%. Of those 58 patients, 37 (47%) had pulmonary fibrosis, 13 (22%) had pulmonary emphysema, and 18 (31%) had other types of advanced lung disease. The six-minute walk distance was significantly greater after the program than before (439 ± 114 m vs. 367 ± 136 m, p = 0.001), the mean increase being 72 m. There were significant point increases in the scores on the following SF-36 domains: physical functioning, up 22 (p = 0.001), role-physical, up 10 (p = 0.045); vitality, up 10 (p < 0.001); social functioning, up 15 (p = 0.001); and mental health, up 8 (p = 0.001). CONCLUSIONS: Pulmonary rehabilitation had a positive impact on exercise capacity and quality of life in patients on lung transplant waiting lists.


2013 ◽  
Vol 8 ◽  
Author(s):  
Nicoleta Bertici ◽  
Ovidiu Fira-Mlădinescu ◽  
Cristian Oancea ◽  
Voicu Tudorache

Background: Effort tolerance and daily physical activity (DPA) are predictive of quality of life and survival in COPD patients, but still remain difficult to assess based on their daily life. The aim of this study was: how to relate pedometry to other classic parameters commonly used in pulmonary rehabilitation (PR). Methods: DPA was evaluated through pedometry. 74 patients with COPD, aged 63.55 ± 8.73 (12 stage II, FEV1 = 60.16 ± 7.78%), (29 stage III, FEV1 = 39.07 ± 6.30%), (33 stage IV, FEV1 = 23.1 ± 7.18%). The monitoring was conducted for a period of 7 days before and 6 months after a pulmonary rehabilitation program (PRP) of 3 weeks. A control group consisting of 21 patients with stable COPD was evaluated initially, but they did not undergo Pulmonary Rehabilitation Program (PRP). After 6 months the patients were re-evaluated using the same parameters. Results and discussion: The values are widely dispersed, with a maximum of 17,420 and minimum of 964 steps/24hrs. The average values acquired were: the lowest in COPD stage IV (2476→3112 steps/24 hrs, p < 0.0001), still with the highest increase over 6 months of PR + 636steps/24hrs; in COPD stage III the increase of DPA was + 597steps/24hrs over 6 months (5627→6224, p < 0.0001), COPD stage II registered the lowest increase + 540steps/24hrs (8724→9264, p < 0.13), probably because the subjects belonging to this stage had the best preserved DPA. The results show moderate correlation between pedometry and the 6MWT and the SGQ. (r = 0.5-0.7). However it demonstrated the positive effects of PRP, even after 6 months. Conclusions: DPA decreases with increasing COPD stage, it is fluctuant with every subject, dependent on clinical status, weather and daily schedule. Wearing pedometers is very easy and motivational, provided that patients realize that they are being “watched”.


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