TY - JOUR T1 - Does the effectiveness of pulmonary rehabilitation vary in patients with different baseline severity of symptoms classified by MRC grade? JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P2239 AU - Emma Tucker AU - Rachel Lardner AU - Joanne Riley AU - Maxine Hardinge Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P2239.abstract N2 - IntroductionPulmonary rehabilitation (PR) as a treatment for chronic lung disease can result in clinically meaningful improvements in health related quality of life (HRQL), and exercise capacity. UK guidelines recommend referral of patients with MRC breathlessness grades 3 and over. However, patients with MRC grade 5 breathlessness are often housebound and less likely to be referred for PR. This study examined whether similar improvements in HRQL and exercise capacity were seen in patients with different MRC grades.Methods490 patients were enrolled in a 7 week PR programme between April 2011 and March 2012. All patients completed Incremental Shuttle Walk Test (ISWT) to measure exercise tolerance and St Georges Respiratory Questionnaire (SGRQ) to measure health related quality of life, pre and post PR. The percentage of patients achieving the minimally important clinical difference (MICD) for ISWT (47.5 metres) and SGRQ (4 points) were calculated for each MRC group.Results383 patients (78%) completed PR, 218 (57%) male: of these 179 (47%) had baseline MRC grade 3 (mean age 70.3), 173 (45%) MRC 4 (mean age 70), and 31 (8%) MRC 5 (mean age 75.3). Fewer patients in MRC grade 5 group (30%) achieved MICD for exercise capacity compared with MRC grade 3 (53%) and MRC grade 4 (61%): but a similar proportion of MRC grade 5 patients (48%) achieved MCID for HRQL measures (52% for both MRC grades 3 and 4).ConclusionExercise capacity improves most after PR in patients with less breathlessness at baseline: however, even patients with severe breathlessness achieve similar clinically significant improvements in HRQL and should be referred for PR. ER -