Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease.

Puhan M, Scharplatz M, Troosters T, Walters EH, Steurer J.

The objective of this review was to assess the effects of pulmonary rehabilitation after COPD exacerbations on future hospital admissions (primary outcome) and other patient-important outcomes (mortality, health-related quality of life and exercise capacity).  Randomized controlled trials comparing pulmonary rehabilitation of any duration after exacerbation of COPD with conventional care were included. Pulmonary rehabilitation programmes needed to include at least physical exercise. Control groups received conventional community care without rehabilitation. Six trials including 219 patients were identified. Pulmonary rehabilitation significantly reduced hospital admissions and mortality. Effects of pulmonary rehabilitation on health-related quality of life were well above the minimal important difference. In all trials, pulmonary rehabilitation improved exercise capacity.

Evidence from small studies of moderate methodological quality suggests that pulmonary rehabilitation is a highly effective and safe intervention to reduce hospital admissions and mortality and to improve health-related quality of life in COPD patients after suffering an exacerbation.

Cochrane Database Syst Rev. 2009, (1), CD005305.

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