Effects of pulmonary rehabilitation in patients with mild-to-moderate chronic obstructive pulmonary disease: Bottom of an iceberg

Özet

Objectives: This study aims to compare the effects of pulmonary rehabilitation (PR) in patients with mild-to-moderate and severe-to-verysevere chronic obstructive pulmonary disease (COPD).Patients and methods: Between January 2005 and December 2010, a total of 76 patients with mild-to-moderate (Global Initiative for ChronicObstructive Lung Disease [GOLD] Stages I+II, n=33, mean age 66.0±8.6 years) and severe-to-very severe (GOLD Stages III+IV, n=43, meanage 63.5±8.8 years) COPD completed an eight-week outpatient PR program. Incremental and endurance shuttle walk tests (ISWT, ESWT),St. George’s Respiratory Questionnaire (SGRQ), Chronic Respiratory Questionnaire (CRQ), and Hospital Anxiety and Depression Scale wereassessed before and after PR. Changes after the intervention were compared between two groups.Results: There were significant improvements in the ISWT and median 60 m [(-150)-(400)] in mild-to-moderate group and 70 m [(0)-(270)]in severe-to-very severe group (both, p<0.001). The ESWT time improved in both groups, 122s [(-279)-(665)] (p=0.002) and 61s [(-180)-(878)] (p<0.001), respectively. Significant effects were observed in all domains of the SGRQ except the impact score in mild-to-moderatepatients. There were significant improvements in all domains except the symptoms score in severe-to-very severe patients. Using the CRQ,a significant improvement was shown in all domains of CRQ except the dyspnea score of mild-to-moderate patients. Anxiety and depressionscores decreased after PR in both groups (p<0.05). According to changes in outcomes, there was no difference in any parameters betweentwo groups.Conclusion: This study demonstrates that patients with mild-to-moderate COPD benefit from PR comparably to patients with severe-to-very-severe COPD. Although patients with mild-to-moderate COPD are not usually symptomatic, our findings suggest that they should beincluded in PR.