Effects of Pulmonary Rehabilitation on Exercise Capacity and Quality of Life in Patients with Stable Chronic Obstructive Pulmonary Disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

SunKai ,  NieHongyu , LiuYong , XuDonglan , GuoWanchun

Department of Respiratory Medicine, Zigong No.4 People's Hospital, Zigong, Sichuan, 643000, China;

Corresponding author：

NieHongyu, Email: 26576628@qq.com

Keywords：

Chronic obstructive pulmonary disease; Pulmonary rehabilitation; Quality of life; BODE index; 6-Minute walking distance; COPD assessment test; Modified British Medical Research Council dyspnea scale

DOI：

10.7507/1671-6205.2014113

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Objective To investigate the effects of pulmonary rehabilitation on the exercise capacity and quality of life in patients with stable chronic obstructive pulmonary disease (COPD) for a optimal strategy for pulmonary rehabilitation. Methods One hundred and six patients with COPD in stable stage were divided into group B (n=37), group C (n=36), and group D(n=33) based on GOLD 2011.Each group of patients were randomly subdivided into a control group(usual care), a pulmonary rehabilitation strategy group 1 (breathing training), and a pulmonary rehabilitation strategy group 2 (breathing training and exercise training), and they were intervened for 24 weeks.Pulmonary function(FEV₁%pred), COPD Assessment Test (CAT), modified British Medical Research Council dyspnea scale(mMRC), BODE index and 6-minute walking distance(6MWD) were compared before and after intervention. Results After pulmonary rehabilitation intervening for 24 weeks, in group B and group C, pulmonary rehabilitation strategy group 2 showed the best effect, CAT, mMRC, BODE index, and 6MWD were proved significantly different before and after pulmonary rehabilitation (P < 0.05).In group D, all indexes had no significant difference between pulmonary rehabilitation strategy group 1 and group 2 before and after pulmonary rehabilitation (P > 0.05), but they were better than those of the control group.Correlation analysis showed that CAT score had significant correlation with FEV₁ % pred, mMRC, BODE index and 6MWD (P < 0.01). Conclusion Patients with different subgroup of COPD based on GOLD 2011 may take different pulmonary rehabilitation strategies to achieve the optimal effect.

Citation： SunKai, NieHongyu, LiuYong, XuDonglan, GuoWanchun. Effects of Pulmonary Rehabilitation on Exercise Capacity and Quality of Life in Patients with Stable Chronic Obstructive Pulmonary Disease. Chinese Journal of Respiratory and Critical Care Medicine, 2014, 13(5): 459-463. doi: 10.7507/1671-6205.2014113 Copy

1.	方晓聪, 王向东, 白春学.慢性阻塞性肺疾病在中国的诊治现状.国际呼吸杂志, 2011, 31:493-497.
2.	COPD Working Group.Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (Revised 2011).www.goldcopd.org, 2011.
3.	张净, 闫汝蕴.COPD患者肺康复运动处方研究进展.中国康复医学杂志, 2010, 25:1220-1224.
4.	Troosters T, Gosselink R, Janssens W, et al.Exercise training and pulmonary rehabilitation:new insights and remaining challenges.Eur Respir Rev, 2010, 19:24-29.
5.	中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版).中华内科杂志, 2007, 46:254-261.
6.	居朝霞, 刘霞英, 陆忠华, 等.呼吸训练在慢性阻塞性肺疾病患者康复中的应用.中国老年学杂志, 2010, 30:284-285.
7.	顾为丽, 陈荣昌.呼吸训练在慢性阻塞性肺疾病患者康复治疗中的应用.中华结核和呼吸杂志, 2012, 35:946-948.
8.	Janaudis-Ferreira T, Hill K, Goldstein RS, et al.Resistance arm training in patients with COPD:a randomized controlled trial.Chest, 2011, 139:151-158.
9.	Jones PW, Harding G, Berry P, et al.Development and first validation of the COPD Assessment Test.Eur Respir J, 2009, 34:648-654.
10.	柴晶晶, 柳涛, 蔡柏蔷.慢性阻塞性肺疾病评估测试中文版临床应用意义的评价.中华结核和呼吸杂志, 2011, 34:256-258.
11.	Ringbaek T, Martinez G, Lange P.A comparison of the assessment of quality of life with CAT, CCQ, and SGRQ in COPD patients participating in pulmonary rehabilitation.COPD, 2012, 9:12-15.
12.	Medinas-Amoros M, Alorda C, Renom F, et al.Quality of life in patients with chronic obstructive pulmonary disease:the predictive validity of the BODE index.Chron Respir Dis, 2008, 5:7-11.
13.	Enright PL, Sherrill DL.Reference equations for the six-minute walk in healthy adults.Am J Respir Crit Care Med, 1998, 158:1384-1387.
14.	Almeida P, Rodrigues F.Exercise training modalities and strategies to improve exercise performance in patients with respiratory disease.Rev Port Pneumol, 2014, 20:36-41.
15.	Breunung L, Roberts M.Peripheral muscle dysfunction and chronic obstructive pulmonary disease.Br J Hosp Med (Lond), 2011, 72:17-18, 20-21.
16.	Vestbo J, Hurd SS, Agusti AG, et al.Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease:GOLD executive summary.Am J Respir Crit Care Med, 2013, 187:347-365.
17.	Beauchamp MK, Nonoyama M, Goldstein RS, et al.Interval versus continuous training in individuals with chronic obstructive pulmonary disease——a systematic review.Thorax, 2010, 65:157-164.
18.	Mador MJ, Krawza M, Alhajhusian A, et al.Interval training versus continuous training in patients with chronic obstructive pulmonary disease.J Cardiopulm Rehabil Prev, 2009, 29:126-132.
19.	Heerema-Poelman A, Stuive I, Wempe JB.Adherence to a maintenance exercise program 1 year after pulmonary rehabilitation:what are the predictors of dropout? J Cardiopulm Rehabil Prev, 2013, 33:419-426.
20.	Gothi D, Joshi JM.Pulmonary rehabilitation in resource poor settings.Indian J Chest Dis Allied Sci, 2011, 53:163-172.
21.	Ninot G, Moullec G, Picot MC, et al.Cost-saving effect of supervised exercise associated to COPD self-management education program.Respir Med, 2011, 105:377-385.
22.	Al Moamary MS.Health care utilization among chronic obstructive pulmonary disease patients and the effect of pulmonary rehabilitation.Med Princ Pract, 2010, 19:373-378.

1. 方晓聪, 王向东, 白春学.慢性阻塞性肺疾病在中国的诊治现状.国际呼吸杂志, 2011, 31:493-497.
2. COPD Working Group.Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (Revised 2011).www.goldcopd.org, 2011.
3. 张净, 闫汝蕴.COPD患者肺康复运动处方研究进展.中国康复医学杂志, 2010, 25:1220-1224.
4. Troosters T, Gosselink R, Janssens W, et al.Exercise training and pulmonary rehabilitation:new insights and remaining challenges.Eur Respir Rev, 2010, 19:24-29.
5. 中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2007年修订版).中华内科杂志, 2007, 46:254-261.
6. 居朝霞, 刘霞英, 陆忠华, 等.呼吸训练在慢性阻塞性肺疾病患者康复中的应用.中国老年学杂志, 2010, 30:284-285.
7. 顾为丽, 陈荣昌.呼吸训练在慢性阻塞性肺疾病患者康复治疗中的应用.中华结核和呼吸杂志, 2012, 35:946-948.
8. Janaudis-Ferreira T, Hill K, Goldstein RS, et al.Resistance arm training in patients with COPD:a randomized controlled trial.Chest, 2011, 139:151-158.
9. Jones PW, Harding G, Berry P, et al.Development and first validation of the COPD Assessment Test.Eur Respir J, 2009, 34:648-654.
10. 柴晶晶, 柳涛, 蔡柏蔷.慢性阻塞性肺疾病评估测试中文版临床应用意义的评价.中华结核和呼吸杂志, 2011, 34:256-258.
11. Ringbaek T, Martinez G, Lange P.A comparison of the assessment of quality of life with CAT, CCQ, and SGRQ in COPD patients participating in pulmonary rehabilitation.COPD, 2012, 9:12-15.
12. Medinas-Amoros M, Alorda C, Renom F, et al.Quality of life in patients with chronic obstructive pulmonary disease:the predictive validity of the BODE index.Chron Respir Dis, 2008, 5:7-11.
13. Enright PL, Sherrill DL.Reference equations for the six-minute walk in healthy adults.Am J Respir Crit Care Med, 1998, 158:1384-1387.
14. Almeida P, Rodrigues F.Exercise training modalities and strategies to improve exercise performance in patients with respiratory disease.Rev Port Pneumol, 2014, 20:36-41.
15. Breunung L, Roberts M.Peripheral muscle dysfunction and chronic obstructive pulmonary disease.Br J Hosp Med (Lond), 2011, 72:17-18, 20-21.
16. Vestbo J, Hurd SS, Agusti AG, et al.Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease:GOLD executive summary.Am J Respir Crit Care Med, 2013, 187:347-365.
17. Beauchamp MK, Nonoyama M, Goldstein RS, et al.Interval versus continuous training in individuals with chronic obstructive pulmonary disease——a systematic review.Thorax, 2010, 65:157-164.
18. Mador MJ, Krawza M, Alhajhusian A, et al.Interval training versus continuous training in patients with chronic obstructive pulmonary disease.J Cardiopulm Rehabil Prev, 2009, 29:126-132.
19. Heerema-Poelman A, Stuive I, Wempe JB.Adherence to a maintenance exercise program 1 year after pulmonary rehabilitation:what are the predictors of dropout? J Cardiopulm Rehabil Prev, 2013, 33:419-426.
20. Gothi D, Joshi JM.Pulmonary rehabilitation in resource poor settings.Indian J Chest Dis Allied Sci, 2011, 53:163-172.
21. Ninot G, Moullec G, Picot MC, et al.Cost-saving effect of supervised exercise associated to COPD self-management education program.Respir Med, 2011, 105:377-385.
22. Al Moamary MS.Health care utilization among chronic obstructive pulmonary disease patients and the effect of pulmonary rehabilitation.Med Princ Pract, 2010, 19:373-378.

Chinese Journal of Respiratory and Critical Care Medicine

Effects of Pulmonary Rehabilitation on Exercise Capacity and Quality of Life in Patients with Stable Chronic Obstructive Pulmonary Disease

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