Introduction:

Pulmonary rehabilitation (PR) has also been shown to be an effective approach in COPD pateients using long-term oxygen therapy (LTOT). In this study, it was aimed to investigate the factors that might determine the effectiveness of PR program in patients with advanced COPD using LTOT with chronic hypoxemic respiratory failure.

Method:

The datas of patients with spirometric stage 3-4 COPD who completed a comprehensive multidipliner PR program, were investigated retrospectively. Patients with systolic pulmonary artery pressure ≤36 mmHg according to echocardiographic evaluation and 19 patients with LTOT (Group I) and 21 patients without exertional desaturation and resting hypoxemia (Group II), were included to the study. The subjects were divided into two groups according to the using LTOT. The values of MRC score, the S. George quality of life questionnaire (SGRQ), incremental shuttle walking test (ISWT) and endurance shuttle walking test (ESWT), body mass and fat-free mass index (BMI, FFMI) performing before and after PR were recorded. The relationship between baseline values before PR and the gainings of PR program was examined.

Results:

Mean value of age was 61±5 year with mean value of FEV1 predicted 32 ±8%. MRC, SGRQ scores and ISWT distances were improved after PR in both groups and the improvements were smiliar between groups. In group I, baseline FEV1 predicted % was not found to be correlated with improvements in exercise capacity and quality of life. In this group the improvements in sensation of dyspnea was found to be less in those with a higher baseline MRC score [ MRC with MRC (p = 0.015, r = -0.550)]. In the group II, there was a significant correlation between baseline FEV1 predicted% and SGRQ total score (p=0,014, r=0,526), between MRC and MRC (p =0.008, r=-0.565), SGRQ activity and total score (respectively p=0,010, r=0,551 /p=0,017, r=0,516), ISWT (p=0,006, r=-0,574).

Conclusion:

Multidisciplinary, comprehensive, outpatients supervised PR program was found to be an effective approach in advanced stage COPD with LTOT as smilar as patients without LTOT and improvements in exercise capacity and quality of life were not shown to be influenced by level of loss in pulmonary function and furthermore in patients who were more dyspneic, the improvements in sensation of dyspnea were found to be less.

Keywords: COPD, dyspnea, LTOT, exercise capacity, quality of life, PR