Effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease: a randomized controlled trial

Abstract

Objective: To test the effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease. Design: Randomized controlled trial. Setting: Pulmonary outpatient department. Subjects: Thirty patients randomly assigned to a rehabilitation (3 men, 9 women, mean age 66 (±2) years) or a control group (10 men, 4 women, mean age 64 (±2) years). Interventions: The patients in the rehabilitation group participated in a multidisciplinary rehabilitation programme comprising exercise training twice weekly, for a 12-week period, nutritional and self-care advice, and education about disease and energy conservation strategies. Main measures: Fatigue, functional limitations due to fatigue, functional performance and satisfaction, six-minute walking distance, hand grip strength and health perception were assessed at baseline and after 12 weeks. Results: At baseline there were no significant differences between the groups, except for gender. The six-minute walking distance was 312.6 (±79.3) m for the rehabilitation group and 360.3 (±84.7) m for the control group. After 12 weeks, the rehabilitation group improved their walking distance by 40.6 (±27.2) m (P<0.05). The rehabilitation group improved in performance (from 4.8 (±2.0) to 6.0 (±1.5) scores, P<0.01) and satisfaction (from 4.6 (±2.2) to 6.0 (±2.1) scores, P<0.001) with regard to own selected daily activities. No statistically significant differences were seen between the changes within the rehabilitation group and changes within the control group at the 12-week follow-up. Conclusions: Although the pulmonary rehabilitation programme had an immediate effect, it was not sustained.