THE EFFECT OF COMPREHENSIVE OUTPATIENT PULMONARY REHABILITATION ON DYSPNEA

To evaluate the effect of outpatient pulmonary rehabilitation (OPR) on dyspnea, we measured this symptom using a visual analogue scale durin g graded treadmill exercise testing and with baseline and transitional dyspnea indices (TDI). The latter measure overall dyspnea in three sp heres: functional impairment, magnitude of task, and magnitude of effo rt. Twenty patients with COPD referred for OPR were randomly assigned to either a treatment group (T, n=10), with dyspnea evaluated at basel ine then shortly following a 6-week OPR program, or a control group (C , n=10), with dyspnea evaluated at baseline then following a 6-week wa iting period. No significant change in maximal exercise performance fr om baseline to repeated testing was observed in either group. Dyspnea at maximum treadmill workload (Dmax), which did not significantly chan ge in C, decreased from 74.4+/-18.9 percent at baseline to 50.5+/-23.2 percent post-OPR in T (p=0.006). The Dmax related to minute ventilati on (Dmax/VEmax) and oxygen consumption (Dmax/Vo(2)max) also significan tly decreased following OPR. The reduction in exertional dyspnea was a pparent by the second minute of exercise. Additionally, TDI focal scor es were significantly higher in T than C (2.3+/-1.06 vs 0.2+/-1.75 uni ts, p=0.006), indicating decreased overall dyspnea following OPR. Thes e results point to significant improvements in both exertional and cli nically assessed dyspnea following OPR.