Long-term effectiveness of pulmonary rehabilitation in patients with chronic airway obstruction

The aim of this study was to evaluate the long-term outcome of an outpatien t pulmonary rehabilitation programme (PRP) in patients with chronic airway obstruction (CAO), In 61 CAO patients (35 asthmatics and 26 chronic obstructive pulmonary dise ase (COPD)) lung and respiratory muscle function, exercise tolerance (by sy mptom limited cycloergometer and walking tests), dyspnoea (Borg scale, visu al analogue scale (VAS), baseline and transitional dyspnoea index (BDI and TDI, respectively)) and quality of life (St George's Respiratory Questionna ire (SGRQ)) were assessed at baseline (t0), at discharge (t1) and 12 months postdischarge (t2). Preprogramme and post-programme hospital admissions an d exacerbations of disease were also recorded, In comparison with baseline, no significant change was observed in lung fun ction tests in either diagnostic group, either at t1 or at t2. In both grou ps improvements in respiratory muscle strength, exercise tolerance, Borg sc ale and VAS reported at t1 were partially reduced at t2, Analysis of varian ce showed that these changes over time mere similar in the two groups, Mean values of SGRQ and BDI/TDI improved at t1, and, unlike exercise tolerance, did not worsen at t2, However, a clinically relevant difference in SGRQ be tween t2 and t0 was reported only in 56% of asthmatics and 52% of CORD pati ents. Compared with the preceding 2 yrs, in the year following PRP, hospita l admissions and disease exacerbations decreased significantly in both diag nostic groups, Regardless of diagnosis, patients with chronic airway obstruction who under went an outpatient pulmonary rehabilitation programme maintained an improve d quality of life 12 months postdischarge despite a partial loss of the imp rovement in exercise tolerance.