The effects of a pulmonary rehabilitation program in relation to the severity of COPD

Introduction. - The aim of this study is to assess the effects of in-patient pulmonary rehabilitation in relation to the stages of COPD according to GOLD and the BODE index. Method. - A prospective cohort study over 4 weeks. The 6-minute walk test, the relationship dyspnoea (EVA)/walking distance, dyspnoea (MRC scale), the Saint-George's respiratory questionnaire and the BODE index were estimated at the beginning and end of a pulmonary rehabilitation programme. Results. - Fifty patients with COPD were included, distributed according to GOLD (II: 30%; III: 32%; IV: 38%) and BODE (quartile 1: 22%; quartile 2: 36%; quartile 3: 26%; quartile 4: 16%). All the patients benefited from the programme. For the GOLD classification, there was no significant difference between stages. For the BODE classification, a significant difference existed between quartiles concerning the evolution of dyspnoea (P=0,025), the relationship dyspnoea/walking distance (P < 0,001) and BODE index (P < 0,001), to the advantage of patients in quartiles 3 and 4. Conclusion. - All patients benefit from rehabilitation in hospital; the most severe benefit the most. The BODE index seems to predict those who make the greatest improvement. (C) 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.