Article

Pulmonary rehabilitation (PR) improves exercise tolerance in patients
with chronic obstructive pulmonary disease. However, it is unclear why some
patients do not improve quality of life during a training program. Our objective
was to evaluate the differences between patients with chronic obstructive
pulmonary disease who improve and those who do not improve quality of life during
a pulmonary rehabilitation program. METHODS: Seventy-three patients underwent a
PR program. All patients trained at 80% (legs) and 50% (arms) of their maximum
load. Incremental and endurance tests, 6-min walk test, and health-related
quality of life with the St George Respiratory Questionnaire (SGRQ) were
measured. We subdivided the groups based on a decrease >/=4 points in the pre-
and post-PR SGRQ total score (G1); <4-point change in the SGRQ total score (G2);
and an increase in scores >/=4 points (G3). RESULTS: Exacerbation frequency (P =
.004) and SGRQ total scores (P < .001) were lower in G1 and G2 than in G3. G1 (P
= .0007) and G2 (P = .0005) significantly improved 6-min walk test distance.
Before PR, G1 and G2 walked greater distances than G3 (P = .003); however, the
difference was no longer significant after PR (P = .34).
A significant load
increase was seen after PR for the 3 groups (P < .05). We found a significant
correlation between the SGRQ and the Charlson index (r = 0.78, P < .0001),
exacerbation frequency (r = 0.72, P < .0001), and basal dyspnea index (r = -0.48,
P < .0001). CONCLUSION: Patients whose quality of life did not improve after
comprehensive PR presented a higher number of disease-related exacerbations with comorbidities.
- BPCO

Langue : ANGLAIS