Rationale:
Little is known about the effects of long-term pulmonary rehabilitation (PR) on perceived dyspnea with activities of daily living (ADL) in patients with chronic lung disease.
Objective:
To assess changes in perception of dyspnea following up to 1 year of supervised PR in patients from multiple outpatient programs.
Methods:
Patients from six North Carolina hospital-based PR programs with chronic obstructive and restrictive lung disease completed the University of California at San Diego Shortness of Breath Questionnaire (SOBQ) at entry and following 12 weeks (w), 24 w, and 52 w of medically supervised PR. A decrease in SOBQ scores indicates less dyspnea with ADL, with a 5-point change indicating minimal clinical significance. Scores were compared across programs pre- and post-PR at each time interval with repeated measures analysis of variance.
Results:
In those who participated in PR for 12 w (N = 715), SOBQ scores decreased from entry to 12 w (54.7 +/- 22.7 to 47.3 +/- 22.7, P < 0.001). In those who participated in PR for 24 w (N = 121), scores decreased from entry to 12 w (54.6 +/- 22.0 to 49.4 +/- 23.9, P = 0.001) and from entry to 24 w (54.6 +/- 22.0 to 47.26 +/- 22.8, P < 0.001), but not from 12 w to 24 w (49.4 +/- 23.9 to 47.3 +/- 22.8, P = 0.403). In those who participated in PR for 52 w (N = 51), scores decreased from entry to 12 w (52.8 +/- 24.1 to 46.2 +/- 23.7, P < 0.05), but not from 12 to 24 w (46.2 +/- 23.7 to 44.2 +/- 24.0, P = 1.0) or from 24 w to 52 w (44.2 +/- 24.0 to 45.3 +/- 25.3, P = 1.0). When analyzed separately, men and women demonstrated these similar trends.
Conclusions:
Men and women of multiple PR programs improved their perception of dyspnea with ADL both clinically and significantly following 12 w participation in medically supervised PR. In the long-term participants, scores decreased but then plateaued after 12 w, remaining both clinically and significantly lower then PR entry levels following up to 1 year of PR participation. Participation in PR is recommended for up to 1 year for maintained improvement of perception of dyspnea with ADL in patients with chronic lung disease.