A comparison of three disease-specific and two generic health-status measures to evaluate the outcome of pulmonary rehabilitation in COPD

The use of health status as an outcome measure is becoming more widespread in pulmonary rehabilitation. There are a number of health status measures b ut the choice remains uncertain. Three disease specific measures and two ge neric measures of health status were employed to observe their relative sen sitivity to a 7-week course of pulmonary rehabilitation. Patients with stable chronic obstructive pulmonary disease (COPD) were recr uited into a rehabilitation programme. They completed a shuttle-walking tes t and three disease-specific questionnaires: the Chronic Respiratory Questi onnaire (CRQ), the St. George's Hospital Respiratory Questionnaire (SGRQ) a nd the Breathing Problems Questionnaire (BPQ). Patients also completed two generic questionnaires: a global quality-of-life scale and an activity chec klist. Ninety-seven patients [58 male mean (sD) age 67 (87) years] complete d the course over a 12-month period. The mean pre-rehabilitation (sD) FEV1 was 1.06 (0.59) 1. The shuttle-walking test and the treadmill-endurance tes t increased significantly after rehabilitation (P < 0.001). All three disease-specific questionnaires improved significantly (the CRQ a nd SGRQ improved beyond minimum clinically important difference). The globa l score improved significantly whilst the 'things people do' decreased. All three disease-specific measures were responsive to pulmonary rehabilitatio n. However the operator-led CRQ appears to be the most sensitive short-term outcome measure.