Effect of Pulmonary Rehabilitation on Patients With Severe and Very Severe COPD and Emphysema

Objective: Chronic obstructive pulmonary disease (COPD) is one of the significant causes of death worldwide. Exercise-induced dyspnea is a common symptom among patients with emphysema dominant-COPD. Decreased exercise capacity and dyspnea are the basis of morbidity of the disease. Pulmonary rehabilitation (PR) is an effective therapy for patients with COPD. Evidence shows, PR improves exercise capacity and the course of the disease. Methods: Fifty-eight patients with severe and very severe COPD in an 8 week-PR program were evaluated retrospectively. Change in spirometric measurements, 6-minute walking test (6-MWT) results, and modified Medical Research Council (mMRC) dyspnea scores were compared pre and post PR. Results: Thirty-four of fifty-eight patients have met the inclusion criteria. Pre- and post-PR measurements of percent predicted forced vital capacity (FVC) were 76.7 +/- 4.6 vs. 77.4 +/- 4.6 (p=0.207); FEV1 were 33.2 +/- 7.1 vs. 37.5 +/- 7.6 (p<0.001) and FEV1/FVC were 43.1 +/- 9.7 vs. 48.2 +/- 10.7 (p<0.001). Distance on 6-MWT were 254.9 +/- 77.6 m vs. 328.1 +/- 93.3 m (p<0.001); mMRC dyspnea scores were 3.14 +/- 0.74 vs. 2.26 +/- 0.66 (p<0.001) pre- and post-PR. Conclusion: PR is an underrated yet very effective therapy for patients with COPD. Instead, of drug-only treatment models, PR is an essential option for the management of COPD. The PR effect on respiratory function and exercise capacity can be more apparent with a more extensive study population.