Pulmonary rehabilitation is successful for COPD irrespective of MRC dyspnoea grade

被引:68
作者
Evans, R. A. [1 ]
Singh, S. J. [1 ]
Collier, R. [1 ]
Williams, J. E. [1 ]
Morgan, M. D. L. [1 ]
机构
[1] Univ Hosp Leicester, Glenfield Hosp, Dept Resp Med Allergy & Thorac Surg, Leicester LE3 9QP, Leics, England
关键词
COPD; Pulmonary rehabilitation; Exercise; MRC dyspnoea scale; SHUTTLE WALKING TEST; CHRONIC-BRONCHITIS; DISEASE COPD; EXERCISE; DISABILITY; OBSTRUCTION; FAILURE; TRIAL; SCALE;
D O I
10.1016/j.rmed.2009.01.009
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: It is not clear whether the benefits of pulmonary rehabilitation (PR) apply equally to patients with Chronic Obstructive Pulmonary Disease (COPD) with different levels of starting disability. We have therefore investigated the effect of pulmonary rehabilitation stratified by the MRC dyspnoea scale in patients with COPD. Methods: This is a retrospective, observational study of data collected from 450 consecutive patients with COPD attending outpatient PR: 247 mate, mean (SD) age 69.5 (8.9) yrs and FEV(1) 44.6 (19.7)% predicted. The Incremental Shuttle Walk Test (ISWT) was performed before and after the seven-week course Results: 395 patients (88%) completed the programme. The mean (SD) baseline ISWT performance was 167 (113)m. The distribution of baseline MRC grades was 2 - 15.4%, 3 - 24.9%, 4 - 27.3% and 5 - 32.4%. The mean (95% CI) improvement in ISWT after PR for each MRC scale grade was highly significant (p < 0.0005); 2 - 66 (50-83)m, 3 - 63 (50-75)m, 4 - 59 (49-70)m, and 5 - 54 (43-64)m. Conclusions: Patients with COPD, of all. MRC dyspnoea grades, benefit comparably from pulmonary rehabilitation achieving both statistically and clinically meaningful improvements in exercise performance. MRC grade should therefore not be used to exclude patients from pulmonary rehabilitation. (C) 2009 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1070 / 1075
页数:6
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