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VOLUME 56 , ISSUE 1 ( January-March, 2014 ) > List of Articles

Original Article

The Effect of a Short-Term Pulmonary Rehabilitation on Exercise Capacity and Quality of Life in Patients Hospitalised with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

Mir Shad Ali, Deepak Talwar, S.K. Jain

Keywords : Pulmonary rehabilitation, COPD, Cardiopulmonary exercise test, 6MWT

Citation Information : Ali MS, Talwar D, Jain S. The Effect of a Short-Term Pulmonary Rehabilitation on Exercise Capacity and Quality of Life in Patients Hospitalised with Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Indian J Chest Dis Allied Sci 2014; 56 (1):13-19.

DOI: 10.5005/ijcdas-56-1-13

License: CC BY-NC 4.0

Published Online: 28-06-2022

Copyright Statement:  Copyright © 2014; The Author(s).


Abstract

Background. Recent research shows that pulmonary rehabilitation (PR) programmes in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD), reduced dyspnoea, improved exercise capacity, and prevented occurrence of further exacerbations. Objective. To evaluate the utility of a 3-week PR programme in patients with AECOPD. Methods. Patients admitted with AECOPD, following clinical stabilisation in the respiratroy intensive care unit (RICU), were alternately assigned to intervention (n=15); and control groups (n=15), respectively. Baseline assessment included spirometry, six-minute walk test (6MWT), symptom limited cardiopulmonary exercise test (CPET), health-related quality of life (HRQoL) assessment by generic questionnaire medical outcomes study short form (S-F 36) questionnaire and dyspnoea evaluation by Borg score. The intervention group patients were treated with usual care plus PR exercises in the form of 20 minutes each of walking, bicycle ergometry and resistance exercises, thrice-weekly for three weeks. The control group patients were treated with only the usual care. After discharge from hospital the treatment regimens were continued on alternate days on outpatient basis, for a total of three weeks. The assessment was repeated in both the groups after three weeks. Results. Nine sessions of PR exercises produced statistically significant improvement in general well-being, forced expiratory volume in the first second (FEV1), 6MWT parameters, exercise capacity, peak oxygen uptake and volume of oxygen consumption (VO2)/Watts slope on CPET in patients with AECOPD. Conclusion. Short duration PR programmes appear to be helpful in the management of AECOPD.

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  1. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease – 2006. Available at URL: http://wwwgoldcopd.com. Accessed on February 21, 2014.
  2. Khirani S, Polese G, Morlini G, Rossi A. Pathophysiology of airflow limitation in COPD. In: Cazolla M, Celli B, Dahl R, editors Therapeutic Strategies in COPD. Oxford: Clinical Publishing Oxford; 2005: p. 27-46.
  3. Wouters EFM. Chronic obstructive pulmonary disease. 5: Systemic effects of COPD. Thorax 2002;57:1067-70.
  4. Engelen MPKJ, Schols AMWJ, Baken WC, Wesseling GJ, Wouters EFM. Nutritional depletion in relation to respiratory and peripheral skeletal function in out-patients with COPD. Eur Respir J 1994;7:1793-7.
  5. Schols AMWJ, Slangen JOS, Volovics LEX, Wouters EFM. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998;157:1791-7.
  6. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. GOLD 2011. Available at URL: http://www.goldcopdorg. Accessed on February 21, 2014.
  7. Seemungal TA, Donaldson GC, Bhowmik A, Jeffries DJ, Wedzicha JA. Time course of recovery of exacerbations in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2000;161:1608-13.
  8. Spencer S, Calverley PM, Burge PS, Jones PW. Impact of preventing exacerbation on deterioration of health status in COPD. Eur Respir J 2004;23:698-702.
  9. Kessler R, Stahl E, Vogelmeier C, Haughney J, Trudeau E, Lofdahl CG, et al. Patient understanding, detection and experience of COPD exacerbations: an observational, interview-based study. Chest 2006;130:33-42.
  10. Donaldson GC, Seemungal TAR, Bhowmik A, Wedzicha JA. Relationship between exacerbation frequency and lung function decline in chronic obstructive pulmonary disease. Thorax 2002;57:847-52.
  11. Connors AF, Jr., Dawson NV, Thomas C, Harrell FE, Desbiens N, Fulkerson WJ, et al. Outcomes following acute exacerbations of chronic obstructive lung disease. The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med 1996;154:959-67.
  12. Gunen H, Hacievliyagil SS, Kosar F, Mutlu LC, Gulbas G, Pehlivan E, et al. Factors affecting survival of hospitalised patients with COPD. Eur Respir J 2005;26:234-41.
  13. Seneff MG, Wagner DP, Wagner RP, Zimmerman JE, Knaus WA. Hospital and 1-year survival of patients admitted to intensive care units with acute exacerbation of chronic obstructive pulmonary disease. JAMA 1995;274:1852-7.
  14. Pulmonary rehabilitation-1999. American Thoracic Society. Am J Respir Crit Care Med 1999;159:1666-82.
  15. American Thoracic Society/European Respiratory Society Statement on Pulmonary Rehabilitation. Am J Respir Crit Care Med 2006;173:1390-1413.
  16. Berry MJ, Rajeski WJ, Adair NE, Zaccaro D. Exercise rehabilitation and chronic obstructive pulmonary disease stage. Am J Respir Crit Care Med 1999;160:1248-53.
  17. Puhan MA, Gimeno-Santos E, Scharplatz M, Troosters T, Walters EH, Steurer J. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Sys Rev 2011(10):CD005305.
  18. Foglio K, Bianchi L, Bruletti G, Battista L, Pagani M, Ambrosino N. Long term effectiveness of pulmonary rehabilitation in patients with chronic airway obstruction. Eur Respir J 1999;13:125-32.
  19. Griffiths TL, Burr ML, Campbell IA, Lewis-Jenkins V, Mullins J, Shiels K, et al. Results at 1 year of outpatient multi disciplinary pulmonary rehabilitation: a randomized controlled trial. Lancet 2000;355:362-8.
  20. Man WD, Polkey MI, Donaldson N, Gray BJ, Moxham J. Community pulmonary rehabilitation after hospitalization for acute exacerbations of chronic obstructive pulmonary disease: randomized controlled study. BMJ 2004;329: 1209-11.
  21. Indian Council of Medical Research. General ethical issues. In: Ethical Guidlines for Biomedical Research on Human Participants. New Delhi: ICMR; 2006:21-33.
  22. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. In: Standardisation of Spirometry. Ed Brusasco V, Crapo R, and Viegi G, Nr 2 in this Series “ATS/ERS Task Force: Standardisation of lung function testing”. Eur Respir J 2005;26:319-38.
  23. American Thoracic Society Statement: Guidelines for the sixminute walk test. Am J Respir Crit Care Med 2002;166:111-7.
  24. American Thoracic Society/American College of Chest Physicians statement on cardiopulmonary exercise testing. Am J Respir Crit Care 2003;167:211-77.
  25. Ware JEJ, Sherbourne CD. The MOS 36-item short-form health survey (SF – 36). Conceptual framework and item selection. Med Care 1992;30:473-83.
  26. Borg GAV. Psychological basis of perceived exertion. Med Sci Sports Exerc 1982;14:377-81.
  27. Bourbeau J, Nault D, Dang-Tan T. Self management and behaviour modification in COPD. Patient Educ Cous 2004;53:271-7.
  28. American Association of Cardiovascular and Pulmonary Rehabilitation. Guidelines for pulmonary rehabilitation programs, 3rd edition. 2004. Available at URL: http://www.HumanKinetics.com. Accessed on February 20, 2014.
  29. Dohoney P, Chromiak JA, Lemire D, Abadie BR, Kovacs C. Prediction of one repetition maximum (1-RM) strength from a 4-6 RM and a 7-10 RM submaximal strength in healthy young adult males. J Exercise Physiol 2002;5:54-59.
  30. Yerg JE, Seals DR Hagberg JM. Effect of endurance training on ventilatory function in older individuals. J Appl Physiol 1985;58:791-4.
  31. Clini E, Foglio K, Bianchi L, Porta R, Vitacca M, Ambrosini N. In-hospital short term training progam for patients with chronic airway obstruction. Chest 2001;120:1500-5.
  32. Puhan MA, Scharplatz M, Trusters T, Steurer J. Respiratory rehabilitation after acute exacerbation of COPD may reduce risk for readmission and mortality: a systematic review. Respir Res 2005;6:54.
  33. Behnke M, Jorres RA, Kirsten D, Magnussen H. Clinical benefits of a combined hospital and home - based exercise programfor over 18 months in patients with severe COPD. Monaldi Arch Chest Dis 2003;59:44-51.
  34. Behnke M, Taube C, and Kirsten D, Lehnigk B, Jorres RA, Magnussen H. Home - based exercise is capable of preserving hospital – based improvements in severe chronic obstructive pulmonary disease. Respir Med 2000;94:1184-91.
  35. Bourbeau J, Julien M, Maltais F, Rouleau M, Beaupre A, Begin R, et al. Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a diseasespecific self management intervention. Arch Intern Med 2003;163:585-91.
  36. Monninkhof E, van der Valk P, van der Palen J, van Herwaardenc C, Zielhuis G. Effects of a comprehensive selfmanagement programme in patients with chronic obstructive lung disease. Eur Respir J 2003;22:815-20.
  37. Bestall JC, Paul EA, Garrod R, Graham R, Jones PW, Wedzicha JA. Longitudinal trends in exercise capacity and health status after pulmonary rehabilitation in patients with COPD. Respir Med 2003;97:173-80.
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