Abstract
Chronic obstructive pulmonary disease (COPD) is an heterogeneous disease with various clinical and functional phenotypes, hence individualization of treatment strategies, such as pulmonary rehabilitation (PR), is important. Our aim was to explore the importance of post-bronchodilator forced vital capacity (pbFVC) in determining the effects of a PR programme on several patient-oriented outcomes. In the absence of any comorbid restrictive disorder (such as pleural thickening, healed TBC, combined fibrosis, kyphoscoliosis, morbid obesity etc.), FVC reflects the mechanical constraint imposed by the elastic and resistive derangement of the lungs.We have studied 41 COPD patients (FEV1 39±10% pred.) who completed a 3-month 25-session PR programme and who were evaluated before and after PR in chronic dyspnea (modified MRC scale), exercise capacity [6-min walking distance (6MWD) and peak workrate on a maximal cardiopulmonary exercise testing (WRmax)] and health-related quality of life (SGRQ questionnaire). Patients were classified into 2 groups according to their pbFVC: Group A (FVC ≥ 70% pred., 20 patients, age 64±8 years) and Group B (FVC < 70% pred., 21 patients, age 62±8 years). In patients of Group B we excluded on clinical & imaging grounds the presence of any comorbid disease with a potential to affect FVC. Patients of Group A (FVC≥70%) presented significant post-PR improvements in dyspnea (p=0.008), 6MWD (p=0.005), WRmax (p=0.04) and SGRQ (p<0.001), while patients of Group B (FVC<70%) experienced a significant improvement only in SGRQ (p=0.008). In conclusion, PR seems beneficial mostly in COPD patients who preserve their FVC.
- © 2011 ERS