PMID- 19217765
OWN - NLM
STAT- MEDLINE
DCOM- 20100709
LR  - 20090615
IS  - 1532-3064 (Electronic)
IS  - 0954-6111 (Linking)
VI  - 103
IP  - 7
DP  - 2009 Jul
TI  - Pulmonary rehabilitation is successful for COPD irrespective of MRC dyspnoea 
      grade.
PG  - 1070-5
LID - 10.1016/j.rmed.2009.01.009 [doi]
AB  - BACKGROUND: It is not clear whether the benefits of pulmonary rehabilitation (PR) 
      apply equally to patients with Chronic Obstructive Pulmonary Disease (COPD) with 
      different levels of starting disability. We have therefore investigated the 
      effect of pulmonary rehabilitation stratified by the MRC dyspnoea scale in 
      patients with COPD. METHODS: This is a retrospective, observational study of data 
      collected from 450 consecutive patients with COPD attending outpatient PR: 247 
      male, mean (SD) age 69.5 (8.9) yrs and FEV(1) 44.6 (19.7)% predicted. The 
      Incremental Shuttle Walk Test (ISWT) was performed before and after the 
      seven-week course RESULTS: 395 patients (88%) completed the programme. The mean 
      (SD) baseline ISWT performance was 167 (113)m. The distribution of baseline MRC 
      grades was 2 - 15.4%, 3 - 24.9%, 4 - 27.3% and 5 - 32.4%. The mean (95% CI) 
      improvement in ISWT after PR for each MRC scale grade was highly significant 
      (p<0.0005); 2 - 66 (50-83)m, 3 - 63 (50-75)m, 4 - 59 (49-70)m, and 5 - 54 
      (43-64)m. CONCLUSIONS: Patients with COPD, of all MRC dyspnoea grades, benefit 
      comparably from pulmonary rehabilitation achieving both statistically and 
      clinically meaningful improvements in exercise performance. MRC grade should 
      therefore not be used to exclude patients from pulmonary rehabilitation.
FAU - Evans, R A
AU  - Evans RA
AD  - Dept of Respiratory Medicine, Allergy and Thoracic Surgery, University Hospitals 
      of Leicester, Glenfield Hospital, Leicester LE3 9QP, United Kingdom. 
      rachael.evans@uhl-tr.nhs.uk
FAU - Singh, S J
AU  - Singh SJ
FAU - Collier, R
AU  - Collier R
FAU - Williams, J E
AU  - Williams JE
FAU - Morgan, M D L
AU  - Morgan MD
LA  - eng
PT  - Journal Article
DEP - 20090213
PL  - England
TA  - Respir Med
JT  - Respiratory medicine
JID - 8908438
SB  - IM
MH  - Aged
MH  - Dyspnea/physiopathology/*rehabilitation
MH  - Exercise Therapy
MH  - Exercise Tolerance/*physiology
MH  - Female
MH  - Forced Expiratory Volume/*physiology
MH  - Humans
MH  - Male
MH  - Predictive Value of Tests
MH  - Pulmonary Disease, Chronic Obstructive/physiopathology/*rehabilitation
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
EDAT- 2009/02/17 09:00
MHDA- 2010/07/10 06:00
CRDT- 2009/02/17 09:00
PHST- 2008/09/11 00:00 [received]
PHST- 2008/11/28 00:00 [revised]
PHST- 2009/01/08 00:00 [accepted]
PHST- 2009/02/17 09:00 [entrez]
PHST- 2009/02/17 09:00 [pubmed]
PHST- 2010/07/10 06:00 [medline]
AID - S0954-6111(09)00015-8 [pii]
AID - 10.1016/j.rmed.2009.01.009 [doi]
PST - ppublish
SO  - Respir Med. 2009 Jul;103(7):1070-5. doi: 10.1016/j.rmed.2009.01.009. Epub 2009 
      Feb 13.