LONG-TERM REHABILITATION PROGRAM IN SEVERE COPD: EVOLUTION OF BODE INDEX AND ST. GEORGE'S RESPIRATORY QUESTIONNAIRE SCORES DURING 3 YEARS

Abstract

PURPOSE: 1. Evaluate the changes of BODE index (BI) and St.George's Respiratory Questionnaire scores (SGRQs) after every supervised Pulmonary Rehabilitation program (PRp) repeated for three years in severe COPD; 2. Compare the changes of BI and SGRQs in adherent and non-adherent COPD patients at a long-term PRp. METHODS: Group A: 35 patients with severe COPD completed a 6-weeks PRp, which was repeated every six months for three years. Seven PRp sessions were completed 2-weeks in a hospital and 4-weeks at home. SGRQs and BI were determined before and after every PRp session. A change of BI≥-1 after PRp session qualifies patient as a PR respondent. Group B: 19 patients with the same clinical conditions received only standard care and SGRQs and BI were determined at the moments corresponding to the beginning of every PRp session of the group A. RESULTS: The following number of responders and BI significant (at least p < 0.05) improvement percentage comparative with before values were at the group A after every seven PRp sessions: 1. 26/22.2%; 2. 24/16.7%; 3. 23/18.9%; 4. 20/17.2%; 5. 17/16.7%; 6. 16/15.2%; 7. 14/13.5%. The SGRQs for all members of group A were significantly improved (p < 0.05) after every PRp session compared with the before value as follow: 1. 12.2%; 2. 11.4%; 3. 10.8%; 4. 10.2%; 5. 10.7%; 6. 10.3%; 7. 9.1%. Two, respective, three patients died from the group A, respective, group B. BI and SGRQs have been significantly impaired after three years at the both groups, but more little significant at the respondents of group A that completing seven sessions PRp than at the group B and non-respondents of group A (p < 0.01). Significant correlations were observed between BI and SGRQs. CONCLUSION: Repeated PRp sessions for three years improve every time BI values and SGRQ scores and delay the deterioration of Quality of Life at severe COPD patients who are PR respondents. The PR respondent number has diminished progressively. CLINICAL IMPLICATIONS: Repetition of PRp sessions offers clinical benefits for some severe COPD patient.