Effects of Pulmonary Rehabilitation – a first year experience and evaluation of important outcome parameters
23 February 2017 (online)
Supported by a growing body of evidence, pulmonary rehabilitation (PR) has emerged as an integral part not only in the management of COPD, but also in various other chronic pulmonary conditions. We report on the evaluation of PR outcome parameters collected in the first year after the establishment of “Rehaklinik Enns”, a pulmonary rehabilitation center in close cooperation with a tertiary care university hospital.
Patients attended an individually tailored three-week in-patient pulmonary rehabilitation program according to the 2013 ATS/ERS guidelines between June 2015 and June 2016. Spirometry including body plethysmography, a 6-minute walk test (6MWT) and a COPD assessment test (CAT) were performed at the beginning and the end of the program. Changes in the examined parameters were then compared to the validated minimal clinically important difference (MCID) reported in literature.
Data was available in a total of 637 patients (mean age 61 y, 40.4% female). The most frequent diagnosis was COPD (64.8%), followed by asthma (13.5%), lung cancer (6.4%) and pulmonary embolism (2.7%). An increase in 6MWT above the MCID of 30 meters was observed in 54.9% of all patients. Greater benefits were especially seen in younger patients (< 40 to 60 y) and in more severe COPD (grade II-IV), while patients > 70y and with COPD I had an under-average effect. A reduction in CAT score greater than the MCID of 2 points was evident in 77.2% of all patients, a result below the average was seen among patients < 40y. There were no differences for sex or smoking status concerning 6MWT or CAT changes. Despite considerably lower numbers, also patients with a diagnosis of asthma, ILD, pulmonary embolism or lung cancer seemed to benefit from PR to a similar extent compared to COPD.
PR has clearly shown positive effects across all pulmonary disease entities, largely regardless of sex, age and disease severity.