The Effect of 6 Week Pulmonary Rehabilitation in COPD - A Randomized Control Study

Abstract

PURPOSE: To evaluate an 6 week outpatient-based program of pulmonary rehabilitation in patients with COPD. The correlation of this positive effect using St.George's Respiratory questionnaire (SGRQ), the 6-minute walk test (6-MWT), BORG dyspnea scale, in a resource limited setting. METHODS: This was a prospective, parallel-group randomized controlled study of an outpatient pulmonary rehabilitation program in 100 patients with COPD (94 men and 06 women). The active group (n = 50) took part in a 6 week rehabilitation program, with 2 visits/week to the center [3 h/wk, 1 h of education and 2 hours of endurance and strengthening exercise and walking] and 2 days/week exercise schedule at home. The control group (n = 50) was reviewed routinely as medical outpatients and were given standard medical treatment as per guidelines. The following evaluations were carried out at study entry and after 6 weeks in both the groups : 1) pulmonary function studies 2) 6-minutes walking test 6MWT 3) quality of life using SGRQ and 4) BORG scale of dyspnea. RESULTS: 89 patients completed the study, 45 patients (90%) from the active group (mean age, 59.17 +/- 8.65 years; mean forced expiratory volume in one second (FEV1), 1.19+/-0.37 liter; (51.93 +/- 14.09 % of the predicted value); and 44 patients (88%) from the control group (mean age, 60.11 +/- 9.56 years) mean FEV1 1.12+/- 0.40 liter (49.27 +/- 13.34% of the predicted value). No changes in pulmonary function parameters were observed in the active group and the control group at the end of six weeks. Whereas, there were significant changes in the SGRQ score and its components (13.71 improvement in total integrated scores) for the patients in active group but not for the patients in control group (1.32 improvement in the total integrated score), a significant increase in the mean six minute walk distance was seen in the active group (66.38+/-9.05 meters) but not for the patients of the control group (6.9+/-4.60 meters), we found a reduction of 3.25 points in the active group's BORG Dyspnea scale without any change in the control group's. CONCLUSIONS: A 6 week pulmonary rehabilitation program improves QOL, dyspnea & exercise capacity in COPD patients.