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Canadian Respiratory Journal
Volume 17, Issue 5, Pages 219-223
http://dx.doi.org/10.1155/2010/203236
Original Article

Success in Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

Adrienne S Scott, Marcel A Baltzan, Joel Fox, and Norman Wolkove

Mount Sinai Hospital Montreal, Montreal, Quebec, Canada

Copyright © 2010 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Pulmonary rehabilitation (PR) is beneficial for some, but not all, patients with chronic lung disease.

OBJECTIVES: To determine the success rate of a comprehensive PR program for patients with chronic obstructive pulmonary disease (COPD) and to characterize the differences between responders and nonresponders.

METHODS: A chart review was performed on patients with a clinical diagnosis of COPD who were referred for PR. Success was defined according to clinically important changes in St George’s Respiratory Questionnaire scores and/or 6 min walk test distance.

RESULTS: The majority of subjects were men (58%) with a mean (± SD) age of 69±10 years (n=177). Sixty-two per cent of participants had a successful outcome with PR, with proportionally more responders noting subjective improvement than objective improvement on a 6 min walk test (73% versus 51%). Subjects with poor baseline St George’s Respiratory Questionnaire scores tended to improve the most (P=0.011 [ANOVA]). Successful participants had a greater forced expired volume in 1 s (1.1 L versus 0.9 L; P<0.05) and a lower BODE index (body mass index, airflow obstruction, dyspnea, and exercise capacity index) at baseline (9.6 versus 10.3; P<0.05). Success of PR was not correlated with age, sex, chronic hypoxemic respiratory failure or other chronic conditions. Successful participants were more likely to be compliant and to experience fewer adverse events (P≤0.001).

CONCLUSIONS: Our study reinforced the belief that the majority of participants with COPD benefit from PR. Few baseline characteristics were predictive of success. Subjectively measured improvement occurred more frequently than objectively measured improvement and was greatest in those with the poorest baseline values.