Early pulmonary rehabilitation program (PRP) after hospital admission due to exacerbation in chronic obstructive pulmonary disease (COPD): Results and follow-up

Abstract

Pulmonary rehabilitation is effective in the management of stable COPD, however, its role following an exacerbation of COPD is less studied. A prospective open observational study that included 91 patients with COPD hospitalized for exacerbation. Patients were randomized to intervention group (IG, early PRP) or control group (CG). The PRP included 4 weeks of supervised ambulatory daily aerobic exercise. The following variables were analyzed at 3 and 6 months: walking distance in the six-minute walking test (6MWT), hand grip, muscle mass percentage (MM), Saint-George Respiratory Questionnaire (SGRQ), Modified Medical Research Council dyspnea scale (mMRC), COPD Assessment Test (CAT) and number of exacerbations. The statistical analysis was performed using Mann–Whitney U test considering a statistically significant difference P < 0.05, SPSS (22.0). Forty-three patients (39 men, mean age 71.4 years) were assigned to the IG and 47 (44 men, mean age 73.26 years) to the CG. The 6MWT distance in the IG at 3 and 6 months was 365.89 (SD 93.9) and 383.81 meters (SD 88.7); in the CG, 299.7 (SD 106.7) and 306.8 meters (SD 106.4), P < 0.05. Patients improved in terms of MM, SGRQ, mMRC, CAT and exacerbations at 3 and 6 months in the IG, although without statistical significance. Early PRP improves exercise capacity at 3 and 6 months. To establish more conclusions, it is necessary to expand the sample size.