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Effects of Pulmonary Rehabilitation (PR) on Exercise Capacity (EC) and Quality of Life (QOL) in Indian Patients with Severe COPD

Raju Pangeni, Anant Mohan, Randeep Guleria, G C Khilnani, Karan Madan, Vijay Hadda
European Respiratory Journal 2017 50: PA3724; DOI: 10.1183/1393003.congress-2017.PA3724
Raju Pangeni
1All India Institute of Medical Sciences, Delhi, India
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Anant Mohan
1All India Institute of Medical Sciences, Delhi, India
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Randeep Guleria
1All India Institute of Medical Sciences, Delhi, India
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G C Khilnani
1All India Institute of Medical Sciences, Delhi, India
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Karan Madan
1All India Institute of Medical Sciences, Delhi, India
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Vijay Hadda
1All India Institute of Medical Sciences, Delhi, India
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Abstract

Introduction: Although PR is considered an integral component in COPD management, short term benefits of PR in patients with severe airflow obstruction in an Indian setting is unclear.

Aim: To study the effects of a hospital-based structured PR on EC and QOL in Indian outpatients with severe COPD

Methods: Clinically stable severe COPD patients (FEV1<50% predicted) on optimized medical therapy were randomly assigned to rehabilitation (RG) and control group (CG). The RG attended thrice weekly (24 sessions) of supervised PR program whereas CG received usual outpatient care. Both groups were reassessed at eight weeks. Changes in Six Minute Walk Distance (Δ6MWD) and Saint George’s Respiratory Questionnaire (ΔSGRQ) from the baseline were assessed at eight weeks. Secondary outcomes included changes in spirometry and BODE index. Maximum oxygen uptake (VO2max) was also noted in patients who were able to undergo cardiopulmonary exercise test.

Results: Eighty patients were randomized, 40 in each group; 28 patients (70%) in RG and 30 (75%) in CG completed the study. After eight weeks, RG showed significant improvement in 6MWD and all domains of SGRQ as compared to CG [Δ6MWD: effect size 38.1 meters, 95% CI (21.3-54.8), p=0.001 and SGRQtotal: effect size 11.5, 95% CI (6.9-16.0), p=0.001]. The dyspnea level (mMRC scale) and BODE index decreased only in RG whereas spirometry and VO2max remained unchanged in both groups.

Conclusion: PR improves functional EC, QOL and dyspnea in severe COPD independent of change in peak EC and spirometry, suggesting non-ventilatory benefits of PR. A successful structured hospital-based outpatient PR is feasible in an Indian setting as well.

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Effects of Pulmonary Rehabilitation (PR) on Exercise Capacity (EC) and Quality of Life (QOL) in Indian Patients with Severe COPD
Raju Pangeni, Anant Mohan, Randeep Guleria, G C Khilnani, Karan Madan, Vijay Hadda
European Respiratory Journal Sep 2017, 50 (suppl 61) PA3724; DOI: 10.1183/1393003.congress-2017.PA3724

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Effects of Pulmonary Rehabilitation (PR) on Exercise Capacity (EC) and Quality of Life (QOL) in Indian Patients with Severe COPD
Raju Pangeni, Anant Mohan, Randeep Guleria, G C Khilnani, Karan Madan, Vijay Hadda
European Respiratory Journal Sep 2017, 50 (suppl 61) PA3724; DOI: 10.1183/1393003.congress-2017.PA3724
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