Dr. Ashish Kumar Dubey, Dr. Ravi Shankar Mishra


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.


COPD, pulmonary rehabilitation, dyspnea, FEV1

Full Text:



Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet. 1997;349(9064):1498–1504.

Lopez AD, Shibuya K, Rao C, et al. Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J. 2006; 27(2):397–412.

Vestbo J, Hurd SS, Agustí AG, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187(4): 347–365.

Casaburi R, Kukafka D, Cooper CB, Witek TJ Jr, Kesten S. Improvement in exercise tolerance with the combination of tiotropium and pulmonary rehabilitation in patients with COPD. Chest. 2005;127(3):809–817.

American Thoracic Society; European Respiratory Society. Skeletal muscle dysfunction in chronic obstructive pulmonary disease. A statement of the American Thoracic Society and European Respiratory Society. Am J Respir Crit Care Med. 1999;159(4 Pt 2):S1–S40.

Wüst RC, Degens H. Factors contributing to muscle wasting and dysfunction in COPD patients. Int J Chron Obstruct Pulmon Dis. 2007;2(3):289–300.

Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease (Revised 2011). Available from: http://www.goldcopd.org/uploads/users/files/

GOLD_Report_2011_Feb21_pdf, accessed on September 16, 2012.

Spruit MA, Singh SJ, Garvey C et al. An official american thoracic society/european respiratory society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013;188(8):e13–e64.

Agusti A, Caverley PM, Celli B, Coxson HO, Edwards LD, Lomas DA, et al. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respir Res 2010; 11 : 122-36.

Eisner MD, Anthonisen N, Coultas D, Kuenzli N, Perez-

Padilla R, Postma D, et al. An official American Thoracic Society public policy statement: novel risk factors and the global burden of chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2010; 182 : 693-718.

Lindberg A, Eriksson B, Larsson LG, Rönmark E, Sandström T, Lundbäck B, et al. Seven-year cumulative incidence of COPD in an age-stratified general population sample. Chest 2006; 129 : 879-85.

Lokke A, Lange P, Scharling H, Fabricius P, Vestbo J. Developing COPD: a 25 year follow up study of the general population. Thorax 2006; 61 : 935-9.

Jindal SK, Aggarwal AN, Chaudhry K, Chhabra SK, D’Souza GA, Gupta D, et al. Asthma Epidemiology Study Group. A multicentric study on epidemiology of chronic obstructive pulmonary disease and its relationship with tobacco smoking and environmental tobacco smoke exposure. Indian J Chest Dis Allied Sci 2006; 48 : 23-9.

Fletcher C, Peto R. The natural history of chronic airflow obstruction. BMJ 1977; 1 : 1645-8



GuyattGH,TownsendM,PugsleySO,KellerJL,ShortHD,TaylorDW,et al.Bronchodilatorsinchronicair‑flowlimitation.Effectsonairwayfunction,exercisecapacity,andqualityoflife.AmRevRespirDis1987;135:1069‑74.


Gosselink HA, Wagenaar RC, Keimpemavan AR, Chadwick‑StraverRV.The effect of a rehabilitation programme on patients with obstructive lung disease(Het effect van een revalidatie programma bij patiënt en metCARA).Ned Tijdschr Fysiother 1990;100:193‑9.

CoxNJ,HendricksJC,BinkhorstRA,vanHerwaardenCL.Apulmonaryrehabilitationprogramforpatientswithasthmaandmildchronicobstructivepulmonarydiseases(COPD).Lung 1993;171:235‑44.

StrijbosJH,PostmaDS, van Altena R, Gimeno F,KoëterGH.Acomparisonbetweenanoutpatienthospital‑basedpulmonaryrehabilitationprogramandahome‑carepulmonaryrehabilitationprograminpatientswithCOPD.Afollow‑upof18months.Chest1996;109:366‑72.

RossiG,FloriniF,RomagnoliM,BellantoneT,LucicS,LugliD, et al.Lengthandclinicaleffectivenessofpulmonaryrehabilitationinoutpatientswithchronicairwayobstruction.Chest2005;127:105‑9.

Dodd JW et al, The COPD assessment (CAT): short and medium term response to Pulmonary Rehabilitation, COPD Journal of Chronic Obstructive Pulmonary Disease 9(4):390-4 • April 2012



GriffithsTL,BurrML,CampbellIA,Lewis‑JenkinsV,MullinsJ,Shiels K, et al.Resultsat1yearofoutpatientmultidisciplinarypulmonaryrehabilitation:Arandomizedcontrolledtrial.Lancet 2000;355:362‑8.



  • There are currently no refbacks.