Health-related quality of life improves following pulmonary rehabilitationand lung volume reduction surgery

Study objectives: To evaluate changes in health-related quality of life (HR QL) as assessed by the Medical Outcomes Study Short Form 36-item questionna ire (SF-36) after pulmonary rehabilitation and lung volume reduction surger y (LVRS). Design: Prospective cohort study. Patients: Nineteen patients with severe emphysema who underwent pulmonary r ehabilitation in preparation for LVRS. Interventions: Pulmonary rehabilitation followed by bilateral sequential LV RS. Measurements and results: HRQL assessed by the SF-36 was measured at baseli ne, after pulmonary rehabilitation, and 6 months after LVRS. One-way analys is of variance with repeated measures demonstrated no significant change fr om baseline in any of the eight domains after pulmonary rehabilitation. Sco res for only one domain, vitality, improved significantly after LVRS compar ed with scores after pulmonary rehabilitation. However, significant improve ments over baseline scores were demonstrated after combined preoperative pu lmonary rehabilitation and LVRS in the domains of physical functioning, rol e limitations due to physical problems, social functioning, and vitality. P ulmonary rehabilitation contributed most to the overall improvements in rol e limitations due to physical problems, whereas LVRS contributed mainly to the overall improvements in physical functioning, social functioning, and v itality. Conclusions: Patients with severe emphysema experience significant improvem ents in both physical and social health status as assessed by the SF-36 aft er combined pulmonary rehabilitation and LVRS. Each intervention makes uniq ue and complementary contributions to the overall improvements in HRQL.