Abstract
Background: Only sparse data exist on the effectiveness of PR in asthma concerning AC. Therefore we conducted a prospective observational study to determine the effect of a 3 week inpatient-PR on AC.
Methods: From May to September 2009 all asthma patients of a pulmonary rehabilitation clinic were asked to participate in the study. 201 out of 242 participated (83%). 42.3% were female, mean age 48.4 y, 59.6% suffered from asthma GINA grade 3-4. Obligate components of PR were patient education, physical training, breathing retraining and psychosocial support. Primary outcome was AC (asthma control test, ACT), which was assessed at beginning of PR (T0), at discharge (T1), and 3 (T2), 6 (T3) and 12 months (T4) post PR. The three latter were delivered by mail. 83.5% (T2), 88.0% (T3) and 72.6% (T4) of the patients answered. Secondary short-time outcomes were 6MWD and FeNO, which were measured at the beginning of PR (T0) and at discharge (T1).
Results (mean±sd): act score: T0 16.0±5.2; T1 20.5±4.0*; T2 18.9±4.7*; T3 18.1±4.8*; T4 18.4±4.9*. 6MWD: T0 495.9±94.6m; T1 554.0±97.0m*. FeNO: T0 36.0±38.8ppb; T1 23.3±18.8ppb* (*p values <0,001 versus T0).
Discussion: The mean ACT score at baseline was 16.0 (of 25), indicating an uncontrolled asthma, while the mean score post PR was 20.5, e.g. indicating sufficient AC. Even after 1 year the mean ACT score of 18.4 indicates a significant improvement of AC. The proportion of patients with sufficient AC (ACT 20 - 25) increased from 33.2% to 67.4% after PR and was still 51% after 1 year.
Conclusion: PR lengthens the 6-MWD, reduces FeNO (significant improvement in both) and improves asthma control least for one year.
- © 2011 ERS