Pulmonary Rehabilitation for Chronic Lung Diseases.

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is now the main cause of disability in the developed world. The advance of COPD is related to increasing breathlessness, disability, and periodic hospitalizations. An aging population in the developed world and increasing cigarette consumption in developing countries expand the global impact of this condition. The disorder associated with COPD leads to a decrease in physical activity and failure of functional independence.
 The aim of this study was to evaluate the effects of PR in patients with normal exercise capacity on health-related quality of life and exercise capacity.
 The mean FEV1/FVC was 59.4± 14.1%, and the mean FEV1 was 64.8± 23.0% as expected. Most topics had mild to moderate COPD. The PImax and PEmax were normal. These subjects had no previous participation in home-based or hospital-based PR. All the subjects had normal maximal V˙O2 and work rate before PR.
 After PR there were still considerable improvements in maximal V˙O2 (mean increase of 101.3 mL/min, p <0.001) and work rate (mean increase of 8.2 watts, p<0.001). Ventilation, heart rate, and mean blood pressure were constant following PR. The maximum oxygen pulse at maximum exercise was significantly increased with PR (p<0.02). The SpO2 and end-tidal PCO2 at peak exercise did not significantly improve after PR.
 Although dyspnea scores at rest were low and did not improve significantly with PR, dyspnea at end-exercise was significantly improved after PR (p=0.01). PR should be the responsibility of the clinical management of patients with COPD, even for those with normal exercise capacity. However, the benefits of disease progression, hospitalization, and survival for these patients remain unknown.
 The main role in the management of any chronic disease, including lung disease, is to improve the quality of life (QL) in patients.
 Conclusion; Although strongly recommended by scientific societies pulmonary rehabilitation programs still need to be more widely implemented. PR programs have shown a high level of evidence of benefits in chronic respiratory patients, particularly those with COPD.