Document Detail


The trajectory of change over multiple outcome areas during comprehensive outpatient pulmonary rehabilitation.
MedLine Citation:
PMID:  16509173     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although pulmonary rehabilitation has proven effectiveness in multiple outcome areas, the optimum duration of this intervention is not clear. We evaluated in an observational study the trajectory of change in upper and lower extremity exercise performance, exertional dyspnea and health status over the course of 12 weeks (24 sessions) of pulmonary rehabilitation in individuals with chronic obstructive pulmonary disease. Demonstrating a plateau in response in these areas might be of practical use for pulmonary rehabilitation programs. We measured outcomes at baseline and at four-session (two week) intervals over the course of our comprehensive outpatient pulmonary rehabilitation program. These included treadmill endurance time at approximately 85% of initial maximal workrate, the number of arm lifts per minute, dyspnea at isotime during treadmill walking and the Chronic Respiratory Disease Questionnaire (CRQ) total score. Thirteen patients with chronic obstructure pulmonary disease (COPD) (five male, eight female) were studied; their age was 66 +/- 8 years and their FEV1 was 34 +/- 11% of predicted. Improvement was noted in all four outcome areas very early in the course of pulmonary rehabilitation. Treadmill endurance time and arm lifts increased significantly over baseline by the fourth and eighth session, respectively, and both increased in a near-linear fashion throughout pulmonary rehabilitation. Exertional dyspnea and CRQ also improved very early, with each showing a significant change from baseline by the fourth session. Their improvement, however, appeared to plateau relatively early during the course of pulmonary rehabilitation. Although the numbers studied are small and the applicability of these results to other programs is undetermined, this study does suggest that 20 or more sessions are needed for optimal acute changes in exercise performance, but improvement in dyspnea and quality of life may occur earlier.
Authors:
R ZuWallack; A Hashim; C McCusker; E Normandin; M L Benoit-Connors; B Lahiri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chronic respiratory disease     Volume:  3     ISSN:  1479-9723     ISO Abbreviation:  Chron Respir Dis     Publication Date:  2006  
Date Detail:
Created Date:  2006-03-02     Completed Date:  2006-06-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101197408     Medline TA:  Chron Respir Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  11-8     Citation Subset:  IM    
Affiliation:
The Section of Pulmonary and Critical Care Medicine, St Francis Hospital and Medical Center, Hartford, CT 06105, USA. rzuwalla@stfranciscare.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Dyspnea / physiopathology
Exercise Test
Exercise Tolerance / physiology*
Extremities / physiopathology
Female
Health Status
Humans
Male
Outpatient Clinics, Hospital
Physical Endurance / physiology*
Prospective Studies
Pulmonary Disease, Chronic Obstructive / physiopathology,  rehabilitation*
Quality of Life
Questionnaires

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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