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Pulmonary rehabilitation slows progression of COPD

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Outpatient pulmonary rehabilitation for 3 years can slow the progression of chronic obstructive pulmonary disease (COPD) and improve physical performance, according to study findings in the May 30th issue of BMC Pulmonary Medicine.

The results indicate, contrary to what was previously thought, that pulmonary rehabilitation can reduce the decline in FEV1 seen with COPD, lead author Dr. David Stav, from Tel Aviv University, Israel, told Reuters Health.

This is first study that examined the “physiological outcome of prolonged (3 years) pulmonary rehabilitation,” Dr. Stav said. “Most papers report results of up to 12 weeks of treatment. There are very few up to 1 year.”

The study, a matched controlled trial, featured 80 subjects with moderate to severe COPD who were treated with standard care alone or in combination with an outpatient pulmonary rehabilitation program for 3 years. The program, which was conducted twice a week in groups of 6 to 8 patients, involved exercises of the upper and lower extremities, in addition to integrated physical activity.

FEV1 fell by 74 mL in the rehabilitation group, much lower than the 149-mL reduction seen in the control group (p < 0.001), the report indicates. Researchers also saw a significant early improvement in maximal sustained work and endurance time in the intervention group, and this benefit persisted throughout the study period (p < 0.01). Lastly, pulmonary rehabilitation was associated with a significant reduction in body mass index (p < 0.05), the researchers note. The results suggest that a prolonged course of pulmonary rehabilitation can modify the progression of COPD, although further studies are needed to verify this, Dr. Stav said. He added that his group plans to reevaluate the current cohort after 5 years of rehabilitation to assess the impact of the intervention on survival. Reference:
BMC Pulmonary Medicine 2009;9.