PMID- 27739881
OWN - NLM
STAT- MEDLINE
DCOM- 20171228
LR  - 20200603
IS  - 2325-6621 (Electronic)
IS  - 2329-6933 (Print)
IS  - 2325-6621 (Linking)
VI  - 14
IP  - 1
DP  - 2017 Jan
TI  - Pulmonary Rehabilitation Improves Outcomes in Chronic Obstructive Pulmonary 
      Disease Independent of Disease Burden.
PG  - 26-32
LID - 10.1513/AnnalsATS.201607-551OC [doi]
AB  - RATIONALE: Current practice guidelines recommend pulmonary rehabilitation as an 
      adjunct to standard pharmacologic therapy for individuals with moderate to severe 
      chronic obstructive pulmonary disease (COPD). Whether pulmonary rehabilitation 
      benefits all subjects with COPD independent of baseline disease burden is not 
      known. OBJECTIVES: To test whether pulmonary rehabilitation benefits patients 
      with COPD independent of baseline exercise capacity, dyspnea, and lung function. 
      METHODS: Data from a prospectively maintained database of participants with COPD 
      enrolled in pulmonary rehabilitation at the University of Alabama at Birmingham 
      from 1996 to 2013 were retrospectively analyzed. Subjects were divided into four 
      quartiles based on their baseline level of dyspnea as assessed by the San Diego 
      Shortness of Breath Questionnaire at the initial visit. Similar quartiles were 
      assessed for FEV(1) percent predicted as well as the 6-minute-walk distance 
      (6MWD). The primary outcome was the change in quality of life as measured by the 
      36-item Short Form Health Survey (SF-36). Secondary outcomes were change in 
      dyspnea, 6MWD, and depression scores assessed using the Beck Depression 
      Inventory-II. Differences between baseline and final scores were compared using 
      paired t tests and across quartiles using analysis of variance. MEASUREMENTS AND 
      MAIN RESULTS: A total of 229 subjects were included. Their mean age was 66.5 (SD, 
      9) years. Ninety-one (40%) were female, and 42 (18%) were African American. The 
      mean FEV(1) percent predicted was 46.3% (20.0%). On completion of pulmonary 
      rehabilitation, clinically significant improvements were seen in most components 
      of SF-36: physical function, 11.5 (95% confidence interval [CI], 7.4-15.5; 
      P < 0.001); health perception, 2.1 (95% CI, -0.7 to 4.8; P = 0.12); physical 
      role, 16.7 (95% CI, 10.3-23.1; P < 0.001); emotional role, 14.7 (95% CI, 
      7.1-22.3; P < 0.001); social function, 16.4 (95% CI, 11.3-21.5; P < 0.001); 
      mental health, 5.4 (95% CI, 2.6-8.3; P < 0.001); pain, 5 (95% CI, 1-9.1; 
      P = 0.02); vitality, 12.4 (95% CI, 8.8-16.1; P < 0.001); and depression, 0.01 
      (95% CI, -0.11 to 0.07; P = 0.54). There was no difference in improvement in 
      SF-36 across quartiles of San Diego Shortness of Breath Questionnaire, 6MWD, and 
      FEV(1) percent predicted. CONCLUSIONS: Pulmonary rehabilitation results in 
      significant improvement in quality of life, dyspnea, and functional capacity 
      independent of baseline disease burden.
FAU - Schroff, Praful
AU  - Schroff P
AD  - 1 Division of Pulmonary, Allergy, and Critical Care Medicine.
FAU - Hitchcock, Jason
AU  - Hitchcock J
AD  - 2 Department of Cardiopulmonary Rehabilitation, and.
FAU - Schumann, Christopher
AU  - Schumann C
AD  - 2 Department of Cardiopulmonary Rehabilitation, and.
FAU - Wells, J Michael
AU  - Wells JM
AD  - 1 Division of Pulmonary, Allergy, and Critical Care Medicine.
AD  - 3 UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, 
      Alabama.
FAU - Dransfield, Mark T
AU  - Dransfield MT
AD  - 1 Division of Pulmonary, Allergy, and Critical Care Medicine.
AD  - 3 UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, 
      Alabama.
FAU - Bhatt, Surya P
AU  - Bhatt SP
AD  - 1 Division of Pulmonary, Allergy, and Critical Care Medicine.
AD  - 3 UAB Lung Health Center, University of Alabama at Birmingham, Birmingham, 
      Alabama.
LA  - eng
GR  - K08 HL123940/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PL  - United States
TA  - Ann Am Thorac Soc
JT  - Annals of the American Thoracic Society
JID - 101600811
SB  - IM
MH  - Aged
MH  - Databases, Factual
MH  - Dyspnea/etiology/physiopathology
MH  - *Exercise Tolerance
MH  - Female
MH  - Forced Expiratory Volume
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pulmonary Disease, Chronic 
      Obstructive/complications/physiopathology/*rehabilitation
MH  - Respiratory Therapy/*methods
MH  - Retrospective Studies
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Walk Test
PMC - PMC7263388
OTO - NOTNLM
OT  - chronic obstructive pulmonary disease
OT  - dyspnea
OT  - exercise capacity
OT  - pulmonary rehabilitation
EDAT- 2016/10/16 06:00
MHDA- 2017/12/29 06:00
PMCR- 2018/01/01
CRDT- 2016/10/15 06:00
PHST- 2016/10/16 06:00 [pubmed]
PHST- 2017/12/29 06:00 [medline]
PHST- 2016/10/15 06:00 [entrez]
PHST- 2018/01/01 00:00 [pmc-release]
AID - 10.1513/AnnalsATS.201607-551OC [doi]
PST - ppublish
SO  - Ann Am Thorac Soc. 2017 Jan;14(1):26-32. doi: 10.1513/AnnalsATS.201607-551OC.