Ali Atabaki1, Jonathan Fine, Margaret Haggerty, Corliss Marolda, Dorothy Wakefield, Andrew Yu, Richard ZuWallack. 1. Pulmonary, Critical Care, and Sleep Medicine, Norwalk Hospital, Norwalk, Connecticut (Drs Atabaki and Fine, Ms Haggerty, and Mr Yu); Pulmonary, Critical Care, and Sleep Medicine, St. Francis Hospital and Medical Center, Hartford, Connecticut (Ms Marolda and Dr ZuWallack); and Center for Public Health and Health Policy, University of Connecticut Health Center, Farmington (Ms Wakefield).
Abstract
PURPOSE: To determine whether an as-needed repeated pulmonary rehabilitation (PR) intervention produces a clinically important improvement in exercise capacity. METHODS: The study included a retrospective analysis of characteristics and 6-minute walk distance (6MWD) of patients with chronic obstructive pulmonary disease (COPD) who completed PR at 2 centers. Data were abstracted from all patients with COPD completing 2 courses of rehabilitation and those of randomly sampled patients completing only 1 course of PR. RESULTS: We identified 37 repeaters and selected 69 nonrepeaters for analysis. No significant differences between the 2 groups with regard to age, FEV1 percent predicted, gender, initial 6MWD, improvement in 6MWD, and the percentage of patients achieving the minimal important difference (MID) of ≥ 35 m were observed with the completion of the first rehabilitation. The time between the first and second PR interventions was a mean of 45 ± 24 months. Repeating patients had a decrease of 90 ± 76 m in 6MWD at the beginning of the second rehabilitation course compared with the end of the first intervention (P = .001). Twenty-four (65%) of repeating patients achieved the MID in 6MWD at the end of the second course of PR. Those who achieved the MID in 6MWD during the second course of rehabilitation also tended to have attained greater improvement in this outcome during the first course (P = .07). CONCLUSION: Two-thirds of patients with COPD undergoing repeat PR experienced significant improvement in exercise capacity. Offering PR to patients with COPD on an as-needed basis appears to be beneficial even after a prolonged period of time between the interventions.
PURPOSE: To determine whether an as-needed repeated pulmonary rehabilitation (PR) intervention produces a clinically important improvement in exercise capacity. METHODS: The study included a retrospective analysis of characteristics and 6-minute walk distance (6MWD) of patients with chronic obstructive pulmonary disease (COPD) who completed PR at 2 centers. Data were abstracted from all patients with COPD completing 2 courses of rehabilitation and those of randomly sampled patients completing only 1 course of PR. RESULTS: We identified 37 repeaters and selected 69 nonrepeaters for analysis. No significant differences between the 2 groups with regard to age, FEV1 percent predicted, gender, initial 6MWD, improvement in 6MWD, and the percentage of patients achieving the minimal important difference (MID) of ≥ 35 m were observed with the completion of the first rehabilitation. The time between the first and second PR interventions was a mean of 45 ± 24 months. Repeating patients had a decrease of 90 ± 76 m in 6MWD at the beginning of the second rehabilitation course compared with the end of the first intervention (P = .001). Twenty-four (65%) of repeating patients achieved the MID in 6MWD at the end of the second course of PR. Those who achieved the MID in 6MWD during the second course of rehabilitation also tended to have attained greater improvement in this outcome during the first course (P = .07). CONCLUSION: Two-thirds of patients with COPD undergoing repeat PR experienced significant improvement in exercise capacity. Offering PR to patients with COPD on an as-needed basis appears to be beneficial even after a prolonged period of time between the interventions.
Authors: Angela T Burge; Carla Malaguti; Mariana Hoffman; Alan Shiell; Christine F McDonald; David J Berlowitz; Anne E Holland Journal: Int J Chron Obstruct Pulmon Dis Date: 2022-08-17