Pulmonary rehabilitation in severe chronic obstructive pulmonary disease: Is there any benefit?

Abstract

Background: Pulmonary rehabilitation (PR) is a key pillar in the management of chronic obstructive pulmonary disease (COPD). Nevertheless, adherence to PR is low, especially in advanced COPD patients who frequently suffer from poor health and severely impaired functional capacity.
Objectives: The aim of this study is to evaluate whether a home-based PR programme could benefit severe COPD patients’ physical and respiratory functions.
Method: This is a prospective interventional study in which stage IV COPD patients received a home-based, customised PR programme for 3 weeks. Baseline Barthel functional scale, dyspnoea grade, COPD assessment test (CAT) score and 6-min walking test (6MWT) were all assessed before and after the programme.
Results: Forty patients were enrolled; their mean age was 66.43 ± 2.99 years. A significant reduction in dyspnoea severity was observed, with 40% of patients reaching grade I and 37.5% becoming grade II, while on the other hand, grade III, the most prevalent pre-PR grade, was reduced (7.5%) at the end of the 3 weeks. The mean CAT score, Barthel score and 6MWT distance showed a highly significant (HS) reduction (p < 0.001).
Conclusion: Home-based, low-intensity PR programmes could be beneficial in severe COPD and can serve as an alternative in case of difficulties in attending clinical settings.
Contribution: Home-based PR programmes may ensure long-term adherence to rehabilitation, which decreases patients’ disabilities and facilitates a shift towards positive lifestyle changes.