Long-term benefits of short-stay inpatient pulmonary rehabilitation in severe chronic obstructive pulmonary disease.

ABSTRACT

The beneficial effects of pulmonary rehabilitation programmes on the overall quality of life in patients with chronic obstructive pulmonary disease (COPD) has been well documented. However, there has been a paucity of studies demonstrating the long-term benefits of short-stay inpatient pulmonary rehabilitation (SSIPR) programmes in patients with severe COPD (forced expiratory volume in one second (FEV1) < 40% of predicted). The authors have previously reported that their multidisciplinary SSIPR programme improved outcome measurements immediately post-rehabilitation in 38 patients with severe COPD. The purpose of this study was to evaluate the long-term (1-yr follow-up) benefits of SSIPR in these patients. The outcome measurements used were timed 12-min walking distance, Borg dyspnoea scale, annual days of acute care hospitalization, and Pulmonary Functional Status Scale. All outcome measurements were significantly improved at 1 yr post-SSIPR as compared to pre-SSIPR values. The 12-min walking distance was significantly improved in patients 1 yr post-SSIPR (251 m) as compared to either pre-SSIPR (133 m, p < 0.0001) or immediately post-SSIPR (224 m, p < 0.01). The number of annual days of acute care hospitalization was reduced from 15.4 pre-SSIPR to 3.8 (p < 0.0001) 1 yr post-SSIPR. The Borg dyspnoea scale measurement showed improvement, both at rest and after 12 min walking at 1 yr post-SSIPR. Also, the Pulmonary Functional Status Scale analysis showed significant (p < 0.001) sustained improvement at 1 yr post-SSIPR as compared to pre-SSIPR. In conclusion, it has been demonstrated that long-term sustained outcome benefits can be achieved from a comprehensive short-stay inpatient pulmonary rehabilitation programme for patients with severe chronic obstructive pulmonary disease.