Airflow grades, outcome measures and response to pulmonary rehabilitation in individuals after an exacerbation of severe chronic obstructive pulmonary disease

•Pulmonary rehabilitation (PR) is recommended after COPD exacerbations.•We need priority access criteria to programs according to baseline characteristics.•Airflow severity grades or outcomes assessed do not influence success rate of PR.•Barthel dyspnoea index and short physical performance battery...

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Bibliographic Details
Published in:European journal of internal medicine 2023-01, Vol.107, p.81-85
Main Authors: Vitacca, Michele, Paneroni, Mara, Salvi, Beatrice, Spanevello, Antonio, Ceriana, Piero, Bruschi, Claudio, Balbi, Bruno, Aliani, Maria, Ambrosino, Nicolino
Format: Article
Language:English
Subjects:
Disease impact
Dyspnea - etiology
Dyspnoea
Exercise capacity
Exercise training
Humans
Outcome Assessment, Health Care
Physical performance
Pulmonary Disease, Chronic Obstructive
Quality of Life
Retrospective Studies
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Summary:•Pulmonary rehabilitation (PR) is recommended after COPD exacerbations.•We need priority access criteria to programs according to baseline characteristics.•Airflow severity grades or outcomes assessed do not influence success rate of PR.•Barthel dyspnoea index and short physical performance battery are sensitive to PR. Individuals with COPD may be staged according to symptoms and exacerbation history (GOLD groups: A-D) and on airflow obstruction (GOLD grades: 1–4). Guidelines recommend pulmonary rehabilitation (PR) for these individuals, including those recovering from an exacerbation (ECOPD) To evaluate whether in individuals with clinically severe COPD, recovering from an ECOPD, the effect size of an in-hospital PR program would be affected by airflow severity grades and assessed outcome measures. Retrospective, multicentre study. Participants were compared according to different GOLD airflow grades. In addition to the MRC dyspnoea scale, six-minute walking distance test and COPD assessment test (CAT), Barthel dyspnoea index (Bid), and Short Physical Performance Battery (SPPB) were assessed, evaluating the proportion of individuals reaching the minimum clinically important difference (MCID) (responders). Data of 479 individuals, completing the program were evaluated. Most of the participants were allocated in GOLD grades 4, (57.6%) and 3 (22.1%). All outcome measures significantly improved after PR (p 
ISSN:0953-6205
1879-0828
DOI:10.1016/j.ejim.2022.11.011