PMID- 19447015
OWN - NLM
STAT- MEDLINE
DCOM- 20091124
LR  - 20220321
IS  - 1532-3064 (Electronic)
IS  - 0954-6111 (Linking)
VI  - 103
IP  - 10
DP  - 2009 Oct
TI  - Effects of early inpatient rehabilitation after acute exacerbation of COPD.
PG  - 1526-31
LID - 10.1016/j.rmed.2009.04.011 [doi]
AB  - We have undertaken an observational retrospective cohort study to assess 
      feasibility and clinical effectiveness of early rehabilitation in patients 
      recovering from acute exacerbation of COPD (AECOPD). A cohort of 1826 inpatients 
      (73% male, age 70+/-8 yrs, FEV(1) 50+/-16% pred.) admitted to a pulmonary 
      rehabilitation (PR) program and completing at least 15 sessions were divided into 
      categories according to their dyspnoea grade (Medical Research Council--MRC 
      scores 2-5) as assessed before AECOPD. The pre-post changes in 6-minute walking 
      distance (6MWD) test, perceived end-effort dyspnoea (Borg scale), and 
      self-reported quality of life (St. George's respiratory Questionnaire: SGRQ) were 
      measured throughout. Absolute change in 6MWD (52 [95%CI 45-59], 65 [95%CI 60-70], 
      63 [95%CI 59-66], and 70 [95%CI 67-74] meters in MRC 2-5 respectively) and the 
      percentage of patients achieving the minimal clinically important difference 
      (MCID) of +54 m (40, 55, 57, and 61%, respectively, p=0.001) differed across MRC 
      grades. Proportion of patients able to reach > or = 350 m at the 6MWD after PR 
      was higher in MRC 4 and 5 (18 and 22%) as compared to MRC 2 and 3 (6 and 15%). 
      Early PR in a cohort of AECOPD patients is feasible and it is associated to 
      clinically meaningful improvement in exercise tolerance independent on the 
      severity of dyspnoea. The proportion of patients reaching the limit of > or = 350 
      m after this intervention is higher in the most severe patients.
FAU - Clini, Enrico M
AU  - Clini EM
AD  - Department Oncology, Haematology and Pneumology, University of Modena, Modena, 
      Italy. enrico.clini@unimore.it
FAU - Crisafulli, Ernesto
AU  - Crisafulli E
FAU - Costi, Stefania
AU  - Costi S
FAU - Rossi, Giuseppina
AU  - Rossi G
FAU - Lorenzi, Cristina
AU  - Lorenzi C
FAU - Fabbri, Leonardo M
AU  - Fabbri LM
FAU - Ambrosino, Nicolino
AU  - Ambrosino N
LA  - eng
PT  - Journal Article
DEP - 20090515
PL  - England
TA  - Respir Med
JT  - Respiratory medicine
JID - 8908438
SB  - IM
MH  - Aged
MH  - Dyspnea/etiology/physiopathology/*rehabilitation
MH  - Feasibility Studies
MH  - Female
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Outcome Assessment, Health Care/statistics & numerical data
MH  - Pulmonary Disease, Chronic 
      Obstructive/complications/physiopathology/*rehabilitation
MH  - Quality of Life/psychology
MH  - Respiratory Function Tests
MH  - Retrospective Studies
MH  - Surveys and Questionnaires
MH  - Walking/physiology
EDAT- 2009/05/19 09:00
MHDA- 2009/12/16 06:00
CRDT- 2009/05/19 09:00
PHST- 2009/01/07 00:00 [received]
PHST- 2009/04/03 00:00 [revised]
PHST- 2009/04/13 00:00 [accepted]
PHST- 2009/05/19 09:00 [entrez]
PHST- 2009/05/19 09:00 [pubmed]
PHST- 2009/12/16 06:00 [medline]
AID - S0954-6111(09)00129-2 [pii]
AID - 10.1016/j.rmed.2009.04.011 [doi]
PST - ppublish
SO  - Respir Med. 2009 Oct;103(10):1526-31. doi: 10.1016/j.rmed.2009.04.011. Epub 2009 
      May 15.