Edwin K Luk1, Fary Khan2, Louis Irving3. 1. Royal Melbourne Hospital - Royal Park Campus, 34 Poplar Road, Parkville, VIC, 3052, Australia. edwin.luk@mh.org.au. 2. Royal Melbourne Hospital - Royal Park Campus, 34 Poplar Road, Parkville, VIC, 3052, Australia. 3. Royal Melbourne Hospital, Grattan Street, Parkville, VIC, 3050, Australia.
Abstract
PURPOSE: Pulmonary rehabilitation (PR) is an accepted intervention for individuals with chronic obstructive pulmonary disease. Despite initial improvements following PR, many patients eventually return to baseline function or decline even further. The aim of this study is to look at long-term (>1 year) outcomes following PR. METHODS: This was a prospective cohort study of patients who had completed PR. Participants were invited for an assessment consisting of participant interviews and clinical assessments using standardised instruments. RESULTS: 129 patients between 2003 and 2012 completed rehabilitation and were eligible. 88 patients were included in the analysis. The mean time of the long-term assessment was 22 months following PR. The mean age was 71 years. Mean FEV1 was 46%. There was a statistically significant (p < 0.001) increase in the incremental shuttle walk test distance of 29.0 m following PR but this gain was lost at the long-term reassessment. Chronic Respiratory Questionnaire (CRQ) scores showed a statistically significant (p < 0.001) increase in all four domains but only the domains of dyspnoea and fatigue remained statistically significant (p < 0.001, p < 0.01, respectively) at the long-term reassessment. Hospital Anxiety and Depression Scale scores reduced following rehabilitation but only the anxiety component was statistically significant (p < 0.01). These improvements persisted at the long-term reassessment but were not statically significant. CONCLUSIONS: This study confirms that many of the functional gains achieved in PR are lost in the longer term. Regular surveillance or monitoring of these patients post-PR is important to identify those requiring further intervention.
PURPOSE: Pulmonary rehabilitation (PR) is an accepted intervention for individuals with chronic obstructive pulmonary disease. Despite initial improvements following PR, many patients eventually return to baseline function or decline even further. The aim of this study is to look at long-term (>1 year) outcomes following PR. METHODS: This was a prospective cohort study of patients who had completed PR. Participants were invited for an assessment consisting of participant interviews and clinical assessments using standardised instruments. RESULTS: 129 patients between 2003 and 2012 completed rehabilitation and were eligible. 88 patients were included in the analysis. The mean time of the long-term assessment was 22 months following PR. The mean age was 71 years. Mean FEV1 was 46%. There was a statistically significant (p < 0.001) increase in the incremental shuttle walk test distance of 29.0 m following PR but this gain was lost at the long-term reassessment. Chronic Respiratory Questionnaire (CRQ) scores showed a statistically significant (p < 0.001) increase in all four domains but only the domains of dyspnoea and fatigue remained statistically significant (p < 0.001, p < 0.01, respectively) at the long-term reassessment. Hospital Anxiety and Depression Scale scores reduced following rehabilitation but only the anxiety component was statistically significant (p < 0.01). These improvements persisted at the long-term reassessment but were not statically significant. CONCLUSIONS: This study confirms that many of the functional gains achieved in PR are lost in the longer term. Regular surveillance or monitoring of these patients post-PR is important to identify those requiring further intervention.
Authors: Martijn A Spruit; Sally J Singh; Chris Garvey; Richard ZuWallack; Linda Nici; Carolyn Rochester; Kylie Hill; Anne E Holland; Suzanne C Lareau; William D-C Man; Fabio Pitta; Louise Sewell; Jonathan Raskin; Jean Bourbeau; Rebecca Crouch; Frits M E Franssen; Richard Casaburi; Jan H Vercoulen; Ioannis Vogiatzis; Rik Gosselink; Enrico M Clini; Tanja W Effing; François Maltais; Job van der Palen; Thierry Troosters; Daisy J A Janssen; Eileen Collins; Judith Garcia-Aymerich; Dina Brooks; Bonnie F Fahy; Milo A Puhan; Martine Hoogendoorn; Rachel Garrod; Annemie M W J Schols; Brian Carlin; Roberto Benzo; Paula Meek; Mike Morgan; Maureen P M H Rutten-van Mölken; Andrew L Ries; Barry Make; Roger S Goldstein; Claire A Dowson; Jan L Brozek; Claudio F Donner; Emiel F M Wouters Journal: Am J Respir Crit Care Med Date: 2013-10-15 Impact factor: 21.405
Authors: Maarten Van Herck; Jeanine Antons; Jan H Vercoulen; Yvonne M J Goërtz; Zjala Ebadi; Chris Burtin; Daisy J A Janssen; Melissa S Y Thong; Jacqueline Otker; Arnold Coors; Mirjam A G Sprangers; Jean W M Muris; Judith B Prins; Martijn A Spruit; Jeannette B Peters Journal: J Clin Med Date: 2019-08-20 Impact factor: 4.241