Chest
Volume 119, Issue 1, January 2001, Pages 77-84
Journal home page for Chest

Clinical Investigations
COPD
Quality of Life Measured With a Generic Instrument (Short Form-36) Improves Following Pulmonary Rehabilitation in Patients With COPD

https://doi.org/10.1378/chest.119.1.77Get rights and content

Study objectives:

The purpose of this study was toevaluate the effects of a 3-week comprehensive pulmonary rehabilitationprogram on quality of life as measured by the Short Form-36 (SF-36) inpatients with COPD.

Design and setting:

We report onthe outcomes of 37 consecutive patients referred for pulmonaryrehabilitation at a respiratory specialty medical center.

Patients:

Thirty-seven patients (mean age, 66 years) with, COPD and severe airflow limitation (mean ± SE FEV1,29.6 ± 1.8% of predicted) were studied.

Interventions:

Rehabilitation consisted of a 3-weekpulmonary rehabilitation program incorporating 12 exercise sessions, each of which included bicycle ergometer exercise training, upper-extremity training, strength training, and stretching, along withpsychosocial counseling and education.

Measurements andresults:

The Health Status Index (SF-36) and 6-min walk test werecompleted before and after rehabilitation. There was an improvement infive of the nine quality-of-life subscales of the SF-36 followingpulmonary rehabilitation. Although there was an improvement infunctional capacity as measured by the 6-min walk, there was nocorrelation between improvement in quality of life and improvement infunctional capacity. There was no correlation between FEV1and improvement in walk distance, but there was a correlation between, FEV1 and improvement in SF-36 physical function andenergy/fatigue subscales.

Conclusion:

Health-relatedquality of life assessed by the SF-36, a general measure of quality oflife, improves following an intensive 3-week pulmonary rehabilitationprogram. Use of the SF-36 allows comparison of the results of pulmonaryrehabilitation to therapeutic interventions in patients with othermedical disorders.

Section snippets

Study Design

We prospectively evaluated the effects of a comprehensive 3-weekpulmonary rehabilitation program on quality of life and 6-min walk testin 37 patients with COPD. Patients were referred to the Pulmonary Rehabilitation Program at the National Jewish Medical and Research Center, Denver, CO. Consecutive patients with a primary diagnosis of, COPD referred over a 10-month period and who agreed to participate wereincluded in the study.

Most patients (32 of 37) underwent pulmonary function testing at

SF-36 Before Rehabilitation

Figure 1 illustrates the SF-36subscales as measured before rehabilitation in the COPD patients inthis study, compared to published values for healthyadults.7 Six of the eight subscales (physical function, role physical, general health, vitality, social function, and roleemotion) were significantly lower in COPD patients than in healthyindividuals. The body pain and the mental health scores for the studygroup were similar to values published for healthyadults.8 The mean values for this COPD

Discussion

This study demonstrates an improvement in HQL using a general toolto measure HQL in patients with COPD following a comprehensivepulmonary rehabilitation program, including medical management, education, exercise training, and psychosocial counseling. Althoughthere was an improvement in 6-min walk distance followingrehabilitation, there was not a significant correlation between theimprovement in HQL and improvement in walk distance, indicatingindependence of these measures.

Quality of life can be

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    Dr. Boueri is supported by Fundaćão de Amparo áPesquisa do Estado de São Paulo (FAPESP), Brazil.

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