Rehabilitation of patients with chronic obstructive pulmonary disease. Exercise twice a week is not sufficient!

Several studies of chronic obstructive pulmonary disease (COPD) have shown that pulmonary rehabilitation, consisting of at least three training sessio ns a week, improves exercise performance and health status. This study inve stigates feasibility, effect and economic aspects of a rehabilitation progr amme consisting of two sessions a week for 8 weeks. Twenty-four patients with moderate COPD were randomized to rehabilitation a nd 21 to placebo, Patients were assigned to an 8-week programme of exercise plus education (Exercise group) or conventional community care (Placebo gr oup). The rehabilitation program was carried out in a hospital outpatient s etting and consisted of 16 h exercise and 13.5 h of education. The exercise group received physiotherapy and education twice a week. Seven patients di d not complete the programme. The characteristics of the 38 COPD-patients a t baseline were the following: (mean+/-SD) forced expiratory volume in 1 se c (FEV1) 1.1+/-0.41 (47% of predicted), 6-min walking distance (6MWD) 413+/ -75 m, score of St. George's Respiratory Questionnaire (SGRQ) 44+/-21. Heal th-status, assessed by SGRQ and The Psychological General Well-being (PGWB) Index, did not improve. Rehabilitation resulted in an insignificant improv ement in the 6MWD [29 m (95% confidence interval: -8 - 66 m)] We conclude t hat a rehabilitation program consisting of exercise and education twice a w eek for 8 weeks had no effect on exercise performance and well being in pat ients with moderate COPD. (C) 2000 HARCOURT PUBLISHERS LTD.