Pulmonary Rehabilitation in COPD: A Case Study

Abstract

Submit Manuscript | http://medcraveonline.com formoterol 12 μg three times a day and mometasone 400 µg, continuously. The patient's height and body mass index (BMI) are 1.58 cm and 22.3 kg/m 2 , respectively. His blood pressure was 140/80 mmHg, heart rate (HR) 64 bpm, respiratory rate (RR) 20 rpm and peripheral oxygen saturation (SpO 2) at rest 95%. Pulmonary auscultation revealed a diffusely reduced vesicular murmur and no alterations were found in cardiac auscultation. The patient was submitted to a pulmonary function test with the following results after the administration of the bronchodilator: FEV1 0.92 (39.2%), FVC 1.79 (59.2%) and FEV1/FVC 51.4 (68.7%). In the 6-minute walk test (6MWT), the patient went through a total of 487.4 meters, without significant variations in heart rate and peripheral oxygen saturation. The quality of life assessment was done using the Saint George's Respiratory Questionnaire (SGRQ). After the initial assessment, the patient was included in the pulmonary rehabilitation program (PRP). The program lasted three months and consisted of three weekly training sessions, one weekly educational session and one weekly meeting with the psychology support group. During the PRP, the patient was instructed to maintain the use of any medications he had been taking previously. The CPET was performed using a protocol for incremental submaximal treadmill with incline, with total incremental time ranging from 8 to 12 minutes. Results and Discussion The patient went through a total of 36 physical training sessions over a period of three months. The results corresponding to the CPET before and after the PRP and the use of the long-acting bronchodilator are described in Table 1. Exercise tolerance time was significantly higher in the post-PRP CPET, but the patient had stopped using the bronchodilator on his own. After the long-acting bronchodilator was re-introduced, the increase in time was even greater in relation to the pre-PRP time. In the initial CPET, the total lung capacity was 470ml, whereas after the test there was an increase to 530ml and 610ml after use of the long-acting bronchodilator. However, it was observed that the perception of dyspnea was lower at 2 min and 14 min of exercise according to the Borg scale. Int Phys Med Rehab J 2018, 3(1): 00082 Abstract Dyspnea is the main symptom in patients with chronic obstructive pulmonary disease (COPD) and bronchodilators are the principal pharmacological treatment. We present a case of a patient treated in a pulmonary rehabilitation program who improved his functional capacity and quality of life. We will discuss the impact of a pulmonary rehabilitation program on cardiopulmonary exercise testing with and without broncodilator.