PMID- 33098829 OWN - NLM STAT- MEDLINE DCOM- 20210924 LR - 20210924 IS - 1931-3543 (Electronic) IS - 0012-3692 (Linking) VI - 159 IP - 3 DP - 2021 Mar TI - Long-Term Benefits of Pulmonary Rehabilitation in Patients With COPD: A 2-Year Follow-Up Study. PG - 967-974 LID - S0012-3692(20)34927-8 [pii] LID - 10.1016/j.chest.2020.10.032 [doi] AB - BACKGROUND: Pulmonary rehabilitation (PR) improves exercise capacity in patients with COPD in the short term. RESEARCH QUESTION: In patients with COPD, does 8 weeks of PR confer long-term benefits on symptoms of dyspnea, anxiety, and depression, and on quality of life, 2 years after completion? STUDY DESIGN AND METHODS: One hundred and sixty-five patients with COPD completed an 8-week, community-based, comprehensive PR program, comprising 2-h sessions twice weekly. Sessions included aerobic exercise and an educational program. Patients were encouraged to perform daily walking exercise up to 30 min at home. We evaluated a number of outcome measures at baseline, 8 weeks, and 2 years, including the following: dyspnea measured with the modified Medical Research Council (mMRC) questionnaire, quality of life assessed with the St. George's Respiratory Questionnaire (SGRQ), and anxiety measured with the Anxiety Inventory for Respiratory Disease (AIR) and the Depression Anxiety Stress Scale (DASS). In addition, we measured exercise capacity, using the Incremental Shuttle Walk Test (ISWT), at baseline and 8 weeks. RESULTS: Mean age (SD) was 72 (8.6) years; 55% were men. At 8 weeks, improvements in mMRC, SGRQ, ISWT, DASS, and AIR were all statistically significant (P < .001). During the 2-year follow-up, changes observed at 8 weeks were maintained for anxiety symptoms, and for symptoms, impact, and total SGRQ scores. In multivariate analysis, initial elevated levels of dyspnea, depression, anxiety, and decreased exercise capacity predicted greater quality of life improvement at 2 years (all P < .001). INTERPRETATION: Over a 2-year period, an effective 8-week PR program provides sustained improvement in anxiety and quality of life. Short-term improvements in dyspnea, depression, and stress symptoms at 8 weeks were not maintained at 2 years. CI - Copyright (c) 2020 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved. FAU - Yohannes, Abebaw M AU - Yohannes AM AD - Department of Physical Therapy, Azusa Pacific University, Azusa, CA. Electronic address: ayohannes@apu.edu. FAU - Dryden, Sheila AU - Dryden S AD - St. Annes Primary Care Center, Lytham, Lancashire, United Kingdom. FAU - Casaburi, Richard AU - Casaburi R AD - Rehabilitation Clinical Trials Center, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA. FAU - Hanania, Nicola A AU - Hanania NA AD - Section of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX. LA - eng PT - Journal Article DEP - 20201022 PL - United States TA - Chest JT - Chest JID - 0231335 SB - IM CIN - Chest. 2021 Mar;159(3):893-894. PMID: 33678267 MH - Aged MH - Anxiety/physiopathology/prevention & control MH - Depression/physiopathology/prevention & control MH - *Exercise/physiology/psychology MH - *Exercise Therapy/education/methods/psychology MH - *Exercise Tolerance MH - Female MH - Home Care Services MH - Humans MH - Male MH - Patient Education as Topic/methods MH - *Pulmonary Disease, Chronic Obstructive/physiopathology/psychology/rehabilitation MH - *Quality of Life MH - Symptom Assessment/methods/statistics & numerical data MH - Time MH - Walking/physiology OTO - NOTNLM OT - COPD OT - anxiety OT - depression OT - pulmonary rehabilitation OT - stress EDAT- 2020/10/26 06:00 MHDA- 2021/09/25 06:00 CRDT- 2020/10/25 00:00 PHST- 2020/03/27 00:00 [received] PHST- 2020/09/27 00:00 [revised] PHST- 2020/10/02 00:00 [accepted] PHST- 2020/10/26 06:00 [pubmed] PHST- 2021/09/25 06:00 [medline] PHST- 2020/10/25 00:00 [entrez] AID - S0012-3692(20)34927-8 [pii] AID - 10.1016/j.chest.2020.10.032 [doi] PST - ppublish SO - Chest. 2021 Mar;159(3):967-974. doi: 10.1016/j.chest.2020.10.032. Epub 2020 Oct 22.