Acute exacerbations of COPD in subjects completing pulmonary rehabilitation

Carr SJ, Goldstein RS, Brooks D

Improvements in health status following pulmonary rehabilitation (PR) diminish with time. This study was designed to characterise the pre- acute exacerbations of COPD (AECOPD) status of patients with moderate or severe COPD who had completed PR. The impact of AECOPDs on health-related quality of life (HRQL) and functional exercise capacity was then measured.

60 subjects who completed PR were enrolled in a 6-month observational study and were followed up until an AECOPD occurred. In the event of an AECOPD, the 6-min walk test (6MWT) and the chronic respiratory disease questionnaire (CRDQ), were repeated 2 weeks after the onset of symptoms.

Baseline airflow obstruction was moderate in 35 subjects and severe in 18 subjects. 34 subjects experienced a moderate or severe AECOPD. The mean distance walked on the baseline 6MWT in those subjects who experienced AECOPDs was 350 m, compared to 416m in those subjects who did not. An AECOPD was associated with significant reductions in 6MWT and in the CRDQ domains of fatigue, emotion, and mastery.

Patients with lower functional exercise capacity are more likely to experience AECOPDs following PR. AECOPDs are associated with significant and clinically meaningful reductions in functional exercise capacity.

Chest 2007, 132: 127-134

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