Effectiveness of pulmonary rehabilitation in improving quality of life in patients with different COPD stages

Abstract

Introduction. Anxiety and depression are frequently associated conditions in COPD patients, and have also significant impact on their quality of life (QoL) and on the course of the disease. Pulmonary rehabilitation (PR) is an adjuvant, non-pharmacological method used in symptomatic COPD patients. The study aimed to evaluate the impact of COPD on QoL depending on disease severity, and to assess the supposedly positive effects of a pulmonary rehabilitation program (PRP) for COPD patients. Material and method. This research included patients with COPD GOLD stages II-IV undergoing bronchodilator therapy. QoL was assessed with the self-administered St George's Respiratory Questionnaire (SGRQ), and depression with the Beck Depression Inventory (BDI). PRP included 3-5 weekly physical training sessions for an average period of 12 weeks, but not less than 3 weeks. Results. The degree of QoL impairment was moderate in stage II (41.07) and severe in stages III (70.28) and IV (81.02). The most severe depression (score 26.6 vs 2.5 in healthy subjects) was also recorded in this group. After the patients underwent all PRP, QoL reassessment at 6 months revealed statistically significant improvements in all 3 groups (p <0.05). In the GOLD COPD stage II group the average reduction was -4.38 units, in the group GOLD COPD stage III -5.37 units, and in the GOLD COPD stage IV -6.75 units. The depression score correlated with the SGRQ score, both of them being higher in the severe stages of disease. BDI administered again 6 months after PRP revealed a significant improvement in average score in all groups, respectively a decrease of -2.17 units in the COPD II group, -2.03 units in the COPD III group and -1.88 units in group COPD IV B group. Conclusion. The results of this study demonstrate a favorable impact of PRP on improving COPD associated symptoms, depression, and QoL in all the 3 monitored COPD patient groups, with statistically significant and persistent positive results over time (6 months after completion of PRP). Key words: COPD, pulmonary rehabilitation program, Quality of life (QoL), depression,