Jácome Cristina, Marques Alda
Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sports, University of Porto, Porto, Portugal (Dr Jácome); and Lab 3R-Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (Drs Jácome and Marques), and Institute for Research in Biomedicine (iBiMED) (Dr Marques), University of Aveiro, Aveiro, Portugal.
J Cardiopulm Rehabil Prev. 2016 Nov/Dec;36(6):445-453. doi: 10.1097/HCR.0000000000000219.
Pulmonary rehabilitation (PR) is effective in patients with moderate to severe chronic obstructive pulmonary disease (COPD). However, the effects of PR in patients with mild COPD have not yet been established. Thus, this study investigated the short- and long-term effects of PR in patients with mild COPD in comparison with patients with moderate to severe disease.
A total of 32 patients with mild (group 1) and 29 with moderate to severe (group 2) COPD completed the study. Both groups participated in a 12-week PR program with exercise training and psychosocial support and education. Outcome measures at baseline, 3 (post-PR), 6, and 9 months later included 6-minute walk test (6MWT); Modified Medical Research Council Dyspnea Scale; 1-repetition maximum chest press and knee extension; a brief physical activity assessment; the number of exacerbations in the past 3 months and the St. George Respiratory Questionnaire (SGRQ).
Improvements in the 6MWT, chest press, knee extension, and physical activity were observed post-PR (P < .001), with no differences between the 2 groups. Reduction in the number of exacerbations (P < .001) and improvements in the SGRQ total (P < .001) were also observed, however, with greater magnitude in group 2 (P = .029 and P < .001, respectively). Except for peripheral muscle strength (P < .002), all the achieved benefits were sustained at 6 and 9 months (P > .05).
Pulmonary rehabilitation improves exercise tolerance, muscle strength, physical activity, and health-related quality of life and reduces exacerbations in patients with mild COPD as it does in patients with moderate to severe COPD. Moreover, most of these benefits were maintained at 9-month follow-up, suggesting that PR could be part of the management of mild COPD.
肺康复（PR）对中度至重度慢性阻塞性肺疾病（COPD）患者有效。然而，PR对轻度COPD患者的疗效尚未明确。因此，本研究调查了PR对轻度COPD患者的短期和长期影响，并与中度至重度患者进行比较。
共有32例轻度COPD患者（第1组）和29例中度至重度COPD患者（第2组）完成了本研究。两组均参加了为期12周的PR计划，包括运动训练、心理社会支持和教育。在基线、3个月（PR后）、6个月和9个月时的结局指标包括6分钟步行试验（6MWT）；改良医学研究委员会呼吸困难量表；1次重复最大量胸部按压和膝关节伸展；简短的身体活动评估；过去3个月内的急性加重次数以及圣乔治呼吸问卷（SGRQ）。
PR后观察到6MWT、胸部按压、膝关节伸展和身体活动均有改善（P <.001），两组之间无差异。还观察到急性加重次数减少（P <.001）和SGRQ总分改善（P <.001），然而，第2组的改善幅度更大（分别为P =.029和P <.001）。除外周肌肉力量外（P <.002），所有获得的益处在6个月和9个月时均得以维持（P >.05）。
肺康复可改善轻度COPD患者的运动耐量、肌肉力量、身体活动和健康相关生活质量，并减少急性加重，这与中度至重度COPD患者的情况相同。此外，这些益处中的大多数在9个月随访时得以维持，表明PR可成为轻度COPD管理的一部分。
