Curative effect of pulmonary rehabilitation in patients with stable moderate to severe chronic obstructive pulmonary disease_Chinese Journal of Respiratory and Critical Care Medicine

Authors：

ZHANG Jing ¹ ,  SHANG Qian ¹ , MA Lijun ¹ , WANG Kai ¹ , REN Xiaozhuan ²

1. Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou, Henan 450000, P. R. China;
2. Department of Ultrasound, Henan Provincial People's Hospital, Zhengzhou, Henan 450000, P. R. China;

Corresponding author：

SHANG Qian, Email: huxineike2448@163.com

Keywords：

Pulmonary rehabilitation; Chronic obstructive pulmonary disease; Diaphragm function; Pulmonary function; Quality of life

DOI：

10.7507/1671-6205.201809002

Video：

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Objective To observe the curative effect of pulmonary rehabilitation in patients with stable moderate to severe chronic obstructive pulmonary disease (COPD).Methods Sixty-four patients with stable moderate to severe COPD who visited during January 2016 and December 2017 were recruited in the study. They were randomly divided into an observation group and a control group, with 32 cases in each group. The spirometry was conducted in all patients. The right deep inspiratory end diaphragm thickness and the quiet end expiratory diaphragm thickness were measured by ultrasound, and the diaphragm thickness fraction (DTF) was calculated. The routine drug treatment was given in both groups. The comprehensive pulmonary rehabilitation treatment was given in the observation group (include breath training, exercise training, health education and nutrition guide). The pulmonary function, diaphragm function, severity and quality of life were evaluated before and 6 months later after the treatment.Results In the observation group, the predicted value of forced expiratory volume in one second (FEV₁%pred), FEV₁/FVC ratio and DTF were all significantly improved compare with before treatment and the control group (all P<0.05). While the BODE index was significantly declined compare with before treatment and the control group (all P<0.05).Conclusion Pulmonary rehabilitation treatment can help improve pulmonary function, diaphragm function, condition of the disease and quality of life.

Citation： ZHANG Jing, SHANG Qian, MA Lijun, WANG Kai, REN Xiaozhuan. Curative effect of pulmonary rehabilitation in patients with stable moderate to severe chronic obstructive pulmonary disease. Chinese Journal of Respiratory and Critical Care Medicine, 2019, 18(4): 314-317. doi: 10.7507/1671-6205.201809002 Copy

1.	Gloeckl R, Schneeberger T, Jarosch I, et al. Pulmonary rehabilitation and exercise training in chronic obstructive pulmonary disease. Dtsch Arztebl Int, 2018, 115(8): 117-123.
2.	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 (2013 年修订版). 中华结核和呼吸杂志, 2013, 36(4): 255-264.
3.	Pirompanich P, Romsaiyut S. Use of diaphragm thickening fraction combined with rapid shallow breathing index for predicting success of weaning from mechanical ventilator in medical patients. J Intensive Care, 2018, 6: 6.
4.	Mannino DM, Homa DM, Akinbami LJ, et al. Chronic obstructive pulmonary disease surveillance--United States, 1971-2000. MMWR Surveill Summ, 2002, 51(6): 1-16.
5.	Celli BR, Cote CG, Matin JM, et al. The body-mass index, airflow obstruction, dyspnea and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350(10): 1005-1012.
6.	Kubincová A, Takáč P, Kendrová L, et al. The effect of pulmonary rehabilitation in mountain environment on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Med Sci Monit, 2018, 24: 6375-6386.
7.	Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2006). [EB/OL]. [2017-02-21]. Available at: www.goldcopd.org.
8.	Ries AL, Bauldoff GS, Carlin BW, et al. Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines. Chest, 2007, 131(5 Suppl): 4S-42S.
9.	Gea J, Pascual S, Casadevall C, et al. Muscle dysfunction in chronic obstructive pulmonary disease: update on causes and biological findings. J Thorac Dis, 2015, 7(10): E418-E438.
10.	Osterling K, MacFadyen K, Gilbert R, et al. The effects of high intensity exercise during pulmonary rehabilitation on ventilatory parameters in people with moderate to severe stable COPD: a systematic review. Int J Chron Obstruct Pulmon Dis, 2014, 9: 1069-1078.
11.	Kodric M, Trevisan R, Torregiani C, et al. Inspiratory muscle training for diaphragm dysfunction after cardiac surgery. J Thorac Cardiovasc Surg, 2013, 145(3): 819-823.
12.	Mota S, Güell R, Barreiro E, et al. Clinical outcomes of expiratory muscle training in severe COPD patients. Respir Med, 2007, 101(3): 516-524.
13.	Hellyer NJ, Andreas NM, Bernstetter AS, et al. Comparison of diaphragm thickness measurements among postures via ultrasound imaging. PM R, 2017, 9(1): 21-25.
14.	Brown PI, Venables HK, Liu H, et al. Ventilatory muscle strength, diaphragm thickness and pulmonary function in world-class powerlifters. Eur J Appl Physiol, 2013, 113(11): 2849-2855.
15.	Breland JY, Hundt NE, Barrera TL, et al. Identification of anxiety symptom clusters in patients with COPD: implications for assessment and treatment. Int J Behav Med, 2015, 22(5): 590-596.
16.	Gupta B, Kant S, Mishra R, et al. Nutritional status of chronic obstructive pulmonary disease patients admitted in hospital with acute exacerbation. J Clin Med Res, 2010, 2(2): 68-74.
17.	Lakhdar R, Rabinovich RA. Can muscle protein metabolism be specifically targeted by nutritional support and exercise training in chronic obstructive pulmonary disease?. J Thorac Dis, 2018, 10(Suppl 12): S1377-S1389.

1. Gloeckl R, Schneeberger T, Jarosch I, et al. Pulmonary rehabilitation and exercise training in chronic obstructive pulmonary disease. Dtsch Arztebl Int, 2018, 115(8): 117-123.
2. 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 (2013 年修订版). 中华结核和呼吸杂志, 2013, 36(4): 255-264.
3. Pirompanich P, Romsaiyut S. Use of diaphragm thickening fraction combined with rapid shallow breathing index for predicting success of weaning from mechanical ventilator in medical patients. J Intensive Care, 2018, 6: 6.
4. Mannino DM, Homa DM, Akinbami LJ, et al. Chronic obstructive pulmonary disease surveillance--United States, 1971-2000. MMWR Surveill Summ, 2002, 51(6): 1-16.
5. Celli BR, Cote CG, Matin JM, et al. The body-mass index, airflow obstruction, dyspnea and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med, 2004, 350(10): 1005-1012.
6. Kubincová A, Takáč P, Kendrová L, et al. The effect of pulmonary rehabilitation in mountain environment on exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Med Sci Monit, 2018, 24: 6375-6386.
7. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease (2006). [EB/OL]. [2017-02-21]. Available at: www.goldcopd.org.
8. Ries AL, Bauldoff GS, Carlin BW, et al. Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines. Chest, 2007, 131(5 Suppl): 4S-42S.
9. Gea J, Pascual S, Casadevall C, et al. Muscle dysfunction in chronic obstructive pulmonary disease: update on causes and biological findings. J Thorac Dis, 2015, 7(10): E418-E438.
10. Osterling K, MacFadyen K, Gilbert R, et al. The effects of high intensity exercise during pulmonary rehabilitation on ventilatory parameters in people with moderate to severe stable COPD: a systematic review. Int J Chron Obstruct Pulmon Dis, 2014, 9: 1069-1078.
11. Kodric M, Trevisan R, Torregiani C, et al. Inspiratory muscle training for diaphragm dysfunction after cardiac surgery. J Thorac Cardiovasc Surg, 2013, 145(3): 819-823.
12. Mota S, Güell R, Barreiro E, et al. Clinical outcomes of expiratory muscle training in severe COPD patients. Respir Med, 2007, 101(3): 516-524.
13. Hellyer NJ, Andreas NM, Bernstetter AS, et al. Comparison of diaphragm thickness measurements among postures via ultrasound imaging. PM R, 2017, 9(1): 21-25.
14. Brown PI, Venables HK, Liu H, et al. Ventilatory muscle strength, diaphragm thickness and pulmonary function in world-class powerlifters. Eur J Appl Physiol, 2013, 113(11): 2849-2855.
15. Breland JY, Hundt NE, Barrera TL, et al. Identification of anxiety symptom clusters in patients with COPD: implications for assessment and treatment. Int J Behav Med, 2015, 22(5): 590-596.
16. Gupta B, Kant S, Mishra R, et al. Nutritional status of chronic obstructive pulmonary disease patients admitted in hospital with acute exacerbation. J Clin Med Res, 2010, 2(2): 68-74.
17. Lakhdar R, Rabinovich RA. Can muscle protein metabolism be specifically targeted by nutritional support and exercise training in chronic obstructive pulmonary disease?. J Thorac Dis, 2018, 10(Suppl 12): S1377-S1389.

Chinese Journal of Respiratory and Critical Care Medicine

Curative effect of pulmonary rehabilitation in patients with stable moderate to severe chronic obstructive pulmonary disease

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