Pulmonary Rehabilitation

Recently I have performed lung function tests for patients who have attended a Pulmonary Rehabilitation (PR) program since their previous testing, which has prompted me to look further into the effectiveness of Pulmonary Rehabilitation on persons with COPD.
Whilst the research has found that Pulmonary Rehabilitation improves health status and quality of life by improving exercise tolerance and shortness of breath, a study by Carone et al (2007) looked into its effectiveness in the most severe category of COPD, i.e. patients with chronic respiratory failure (CRF). They found that PR is equally effective in the most severe category of COPD, i.e. patients with chronic respiratory failure (CRF), and supports the prescription of PR also in these patients.
In another study Riario-Sforza et al (2009)looked at a group of patients with COPD undergoing PR, and evaluated the number needed to treat (NNT) to achieve an increase in physical capacity, as defined by a significant improvement in the six-minute walk test (6MWT). The NNT in the overall study group was 2 and the same NNT was obtained in GOLD stages of COPD 2, 3, and 4, but was 8 in stage 1. They found therefore that PR is highly effective in improving the exercise capacity of patients with COPD, as demonstrated by a valuable NNT, with better results in patients with a more severe disease.
The objective of a third study by Di Meo et al (2008) was to identify predictors of improvement in the 6-minute walked distance (6MWD) in elderly COPD patients after PR. Although they could not develop a model accurately predicting the response to rehabilitation, they concluded from their study that "among elderly patients with COPD, a comprehensive PR programme can significantly improve the 6MWD even in the presence of chronic hypoxemia, and that the most physically impaired patients achieve the greatest benefit from rehabilitation."
This is great news for people with COPD, and especially for those whose condition is worse. Participating in the course will provide improvement in breathlessness, ability to exercise, and quality of life, and the worse the condition is the greater improvement that can be achieved.

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