How Effective is Pulmonary Rehabilitation for COPD?

COPD is a serious, progressive condition that limits airflow into the lungs in ways that are not fully reversible with medications. In 2015, COPD was the third leading specific cause of total disease burden.(1) Each year, roughly one in five people with moderate to severe COPD experience an acute exacerbation requiring urgent care. Hospitalization is also common in these instances. Inpatient care manages the acute episodes, but inadequate chronic disease management will contribute to faster progression and worsening of symptoms.(2)

Pulmonary rehabilitation is a big part of COPD management. This is a program of exercises designed to improve breathing and provide important disease education. Recently, Nina Bausek, PHD published a simple but useful measurement of what people might expect from pulmonary rehab with simple exercises that people could later perform independently at home.(3) Patients received at least eight supervised visits for patient education, upper limb exercises, lower limb exercises, cardiovascular fitness, and respiratory muscle training. Researchers did before and after measures of peak expiratory flow (PEF) and maximum phonation time (MPT). MPT proves important for supporting speech function, while good PEF is known to prevent aspiration pneumonia.(4)

Peak Expiratory Flow: a quick test of the amount and rate of air that can be forcefully breathed out of the lungs.

Maximum Phonation Time: Maximum phonation time measures how many seconds a patient can continuously sound the letter A after rising from a seated position.

After eight visits, 100% of patients experienced improvement in both measures. The average MPT improved from 5.8 seconds to 12.1 seconds, while the average PEF rose from 190.7 liters per minute to 324.5. It is probable that patients who continued their exercises independently saw even greater gains and moderated the progression of their disease.

People at risk of hospitalization for acute COPD episodes should call Advanced Physiotherapy at (02) 4954 5330 to learn more about pulmonary rehabilitation.

References:

1. Australian Institute of Health and Welfare 2019. Australian Burden of Disease Study 2015: Interactive data on disease burden. Australian Burden of Disease Cat. no. BOD 24. Canberra: AIHW.
2. Rubí M, Renom F, Ramis F, Medinas M, Centeno MJ, Górriz M, et al. Effectiveness of pulmonary rehabilitation in reducing health resources use in chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 2010;91: 364–368.
3. Bausek N, Havenga L, Aldarondo S. Respiratory muscle training improves speech and pulmonary function in COPD patients in a home health setting-a pilot study. BioRxiv. 2019 Jan 1:523746.
4. Kim J, Davenport P, Sapienza C. Effect of expiratory muscle strength training on elderly cough function. Arch Gerontol Geriatr. 2009;48: 361–366.