EFFECT OF PULMONARY REHABILITATION IN PATIENTS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A HOSPITAL BASED CROSS SECTIONAL STUDY

Dr. Ashish Kumar Dubey, Dr. Ravi Shankar Mishra

Abstract


Background: Chronic obstructive pulmonary disease(COPD) is an obstructive and progressive airway  disease associated with reduction in daily physical activity and psychological problems related to patient’s disability and poor quality of life. Pulmonary rehabilitation(PR) plays an essential  role in the management of COPD, by breaking the vicious circle of dyspnea–decreased activity–deconditioning–isolation.

Aim: This study aimed to highlight the impact of PR on COPD patients while focusing on the clinical usefulness of PR.

Materials & methods: This study was done over a period of 1.5 years including all the diagnosed cases of COPD (both OPD and IPD) who did not have any acute exacerbation requiring oxygen, not associated with other medical conditions such as heart disease, neurological disease, lumbar spondylitis or osteoarthritis or those unable to perform PFT after taking proper consent. The study was completed with a follow up schedule, monthly, for 3 months. Proforma for the study included demographics, history, examination, dyspnea grading using modified Borg scale as well as CAT questionnaire along with a six-minute walk test and spirometry. Statistical analysis was done using SPSS Version 20 (Chicago Inc., USA). Data comparison was done by applying specific statistical tests to find out the statistical significance of the comparisons. Quantitative variables were compared using mean values and qualitative variables using proportions. Significance level was fixed at P < 0.05.

Results: Out of total 227 cases, only 71 completed the 3-month monthly follow up and hence were used for the statistical analysis. The results showed male:female ratio 80.3:19.7. As per Borg scale, mean fever, chest pain, cough, expectoration and dyspnea score decreased over subsequent follow-up. Rate of hospitalisation was seen more in 61-70 year age group. Mean six-minute walk test value increased continuously during the duration of follow up.

Conclusion: Effective pulmonary rehabilitation that incorporates exercise schedules and patient education comprehensively can encompass treatment and improve the quality of life of patients suffering with COPD.


Keywords


COPD, pulmonary rehabilitation, dyspnea, FEV1

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