Chest
Volume 134, Issue 2, August 2008, Pages 273-280
Journal home page for Chest

Original Research
COPD
Are Patients With COPD More Active After Pulmonary Rehabilitation?

https://doi.org/10.1378/chest.07-2655Get rights and content

Background

Despite a variety of benefits brought by pulmonary rehabilitation to patients with COPD, it is unclear whether these patients are more active during daily life after the program.

Methods

Physical activities in daily life (activity monitoring), pulmonary function (spirometry), exercise capacity (incremental cycle-ergometer testing and 6-min walk distance testing), muscle force (quadriceps and handgrip force, and inspiratory and expiratory maximal pressures), quality of life (chronic respiratory disease questionnaire), and functional status (pulmonary functional status and dyspnea questionnaire-modified version) were assessed at baseline, after 3 months of a multidisciplinary rehabilitation program, and at the end of a 6-month multidisciplinary rehabilitation program in 29 patients (mean [± SD] age, 67 ± 8 years; FEV1, 46 ± 16% predicted).

Results

Exercise capacity, muscle force, quality of life, and functional status improved significantly after 3 months of pulmonary rehabilitation (all p < 0.05), with further improvements in muscle force, functional status, and quality of life at 6 months. Movement intensity during walking improved significantly after 3 months (p = 0.046) with further improvements after 6 months (p = 0.0002). Walking time in daily life did not improve significantly at 3 months (mean improvement, 7 ± 35%; p = 0.21), but only after 6 months (mean improvement, 20 ± 36%; p = 0.008). No significant changes occurred in other activities or in the pattern of the time spent walking in daily life. Changes in dyspnea after the program were significantly related to changes in walking time in daily life (r = 0.43; p = 0.02).

Conclusion

If one aims at changing physical activity habits in the daily life of COPD patients, the contribution of long-lasting programs might be important.

Section snippets

Study Design

In this longitudinal study, physical activities in daily life, pulmonary function, submaximal exercise capacity (6-min walk test [6MWT]), maximal exercise capacity (cycling), respiratory and peripheral muscle force, functional status, and health-related quality of life were assessed before, 3 months after, and 6 months after attending a multidisciplinary pulmonary rehabilitation program. An analysis of the duration of continuously active periods was performed at baseline and at the end of the

Dropouts

Twelve patients (29%) dropped out of the rehabilitation program due to a lack of motivation or personal reasons (n = 7), unrelated problems (ie, orthopedic or GI; n = 4), or a sequence of three consecutive severe acute exacerbations requiring long-term hospitalization (n = 1). There were no statistically significant differences at baseline between the group of patients who dropped out (n = 12) and the group of patients who completed the program (n = 29), including measurements of physical

Discussion

The present study showed that exercise performance, muscle force, health-related quality of life, and functional status improved after 3 months of multidisciplinary pulmonary rehabilitation in COPD patients. However, the changes in physical activities in daily life in this period were limited to an improvement in movement intensity during walking in daily life. Improvement in the time spent walking in daily life was only obtained after 6 months of rehabilitation, together with a trend for

Acknowledgment

The authors thank the following professionals for their contribution to the present study: Iris Coosemans, Veronica Barbier, Ilse Muylaert, Chris Burtin, Anne Cattaert, Paul Baten, Rina Droogmans, Linda Stans, Dirk Delva, Stefaan Ledeganck, and Maarten Govaert.

References (37)

  • F Pitta et al.

    Characteristics of physical activities in daily life in chronic obstructive pulmonary disease

    Am J Respir Crit Care Med

    (2005)
  • J Garcia-Aymerich et al.

    Regular physical activity reduces hospital admission and mortality in chronic obstructive pulmonary disease: a population based cohort study

    Thorax

    (2006)
  • M Coronado et al.

    Walking activity measured by accelerometry during respiratory rehabilitation

    J Cardiopulm Rehabil

    (2003)
  • BG Steele et al.

    Monitoring daily activity during pulmonary rehabilitation using a triaxial accelerometer

    J Cardiopulm Rehabil

    (2003)
  • EM Mercken et al.

    Rehabilitation decreases exercise-induced oxidative stress in chronic obstructive pulmonary disease

    Am J Respir Crit Care Med

    (2005)
  • R Berg-Emons et al.

    Does aerobic training lead to a more active lifestyle and improved quality of life in patients with chronic heart failure?

    Eur J Heart Fail

    (2004)
  • F Pitta et al.

    Effects of pulmonary rehabilitation on physical activities in daily life in COPD patients [abstract]

    Proc Am Thorac Soc

    (2005)
  • F Pitta et al.

    Does pulmonary rehabilitation improve physical activities in daily life in COPD [abstract]?

    Eur Respir J

    (2005)
  • Cited by (0)

    The study was performed at the University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Leuven, Belgium.

    The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

    Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).

    1

    Dr. Pitta is supported by Coordenção de Aperfeiçoamento de Nível Superior (CAPES)/Brasil.

    2

    Dr. Troosters is supported by a postdoctoral fellowship of the Fonds Wetenschappelijk Onderzoek (FWO), Vlaanderen, Belgium.

    View full text