Abstract
Objective: To determine the effects of pulmonary rehabilitation in men and women with a COPD diagnosis in a Colombian clinic. Method: A longitudinal and descriptive study was conducted with 75 COPD patients who entered a pulmonary rehabilitation program during 2018 and 2019. The population was divided into groups according to gender and some sociodemographic characteristics were assessed, such as spirometry expressed in percentage of the predicted value, body mass index, mMRC dyspnea, and capacity for physical exercise, as well as some physiological variables with the six-minute walk test, anxiety-depression (HADS) and quality of life (SGRQ). A p-value<0.05 was considered statistically significant. Results: The cigarette packs smoked per year index was higher in men, 34±29.11 (p<0.001), whereas the exposure to firewood smoke was five times higher in women (p=0.037). All the variables related to the capacity for physical exercise improved significantly (p<0.021), with distance covered standing out: 63.26±60.03 vs. 51.53±61.02 in favor of women. mMRC dyspnea was initially higher in women when compared to men, 0.709±0.287, and presented a greater change in women with 1.294±0.415 when compared to men, 0.736±0.880, at the end of pulmonary rehabilitation. Conclusion: Pulmonary rehabilitation in women shows an increase of 63.26 meters in the distance covered and a 1.294-point reduction in dyspnea; while, for men, these figures were 51.53 meters and 0.736 points, respectively, as well as an improvement in quality of life in men by 11.47 SGRQ points when compared to women: 0.600.
Highlights
Chronic Obstructive Pulmonary Disease (COPD) has historically had a connotation of male predominance, mainly associated with the smoking habit [1]
It is important to consider that, in patients with COPD, two types of interventions are recommended: pharmacological and non-pharmacological, this latter being of great relevance as it includes pulmonary rehabilitation; it has been evidenced that the medical personnel can better diagnose COPD in men than in women, which affects treatment, allowing men greater access to the health services [4,5,6]
This situation can be related to the delay in seeking medical assistance by the women [19] and to the fact that the medical personnel diagnoses the disease to more men because it is related to the smoking habit, which probably leads to more referrals to the pulmonary rehabilitation (PR) programs [5,7]
Summary
Chronic Obstructive Pulmonary Disease (COPD) has historically had a connotation of male predominance, mainly associated with the smoking habit [1]. In other countries, the smoking habit can even be stronger in women, and higher prevalence is evidenced in this population [2,4]. The evidence indicates that men and women can be phenotypically different in their response to the smoke from tobacco, and even to other risk factors of the disease, reason why their intervention needs could vary according to the clinical and functional condition [8]. The benefits of the interventions are manifested both in men and for women, it is important to consider that the effects of pulmonary rehabilitation can bring about different outcomes according to gender, which renders it necessary that, in some conditions, individualization of the interventions be indispensable to denote benefits in similar proportions [8]
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