EFFECTS OF PULMONARY REHABILITATION IN CH RONIC OBSTRUCTIVE PULMONARY-DISEASE OUT-PATIENTS ON EXERCISE TOLERANCE AND QUALITY-OF-LIFE

Respiratory rehabilitation is a multidiciplinary medical approach whic h allows a total care of patients suffering from COPD. Optimisation of bronchodilator treatment, health education, cessation of smoking, die tetic, relaxation and re-entrainment to effort. We report our experien ce concerning 88 BPCO (mean age 62.1, FEV1 of 1.4 litres, or 48% of pr edicted normal); these 88 patients were cared for on an ambulatory bas is at our centre for two hours per session, three times per week for s even weeks. The objective results were analysed on exercise tests befo re and after treatment. For ventilation, there was a significant impro vement in the power developed (from 45.5+/-17.1 to 53.4+/-23 watts; p< 0.001) without any change in the oxygen consumption (VO2), ventilation (VE) or heart rate (FC) and of oxygen pulse (VO2/FC). For the same le vel of power (80% of maximum power for the initial exercise test) ther e was a significant lowering of ventilation (V=33.5+/-9.4 to 30.7+/-7. 4 litres per minute, p<0.001), cardiac frequency (FC: from 116.9+/-16 to 111.1+/-13.1 beats per minute, p<0.001) as well as the oxygen pulse (VO2/FC: from 7.9+/-2.7 to 8.3+/-3.7). At the maximum on the exercise test all the parameters studied were significantly better: watts, VO2 , VE, cardiac frequency and VO2/FC. A study of the visual analogue sca le (EVA), analysing sleep, anxiety, dyspnoea and the physical aspects showed a significant improvement in the four subjective parameters. Re spiratory rehabilitation of BPCO practised as an out patient has shown an improvement in exercise tolerance in every day activities and impr ovement in dyspnoea and in the quality of life.