Article

PURPOSE: To determine whether an as-needed repeated pulmonary rehabilitation (PR)
intervention produces a clinically important improvement in exercise capacity.
The study included a retrospective analysis of characteristics and
6-minute walk distance (6MWD) of patients with chronic obstructive pulmonary
disease (COPD) who completed PR at 2 centers. Data were abstracted from all
patients with COPD completing 2 courses of rehabilitation and those of randomly
sampled patients completing only 1 course of PR. RESULTS: We identified 37
repeaters and selected 69 nonrepeaters for analysis. No significant differences
between the 2 groups with regard to age, FEV1 percent predicted, gender, initial
6MWD, improvement in 6MWD, and the percentage of patients achieving the minimal
important difference (MID) of >/= 35 m were observed with the completion of the
first rehabilitation. The time between the first and second PR interventions was
a mean of 45 +/- 24 months. Repeating patients had a decrease of 90 +/- 76 m in
6MWD at the beginning of the second rehabilitation course compared with the end
of the first intervention (P = .001). Twenty-four (65%) of repeating patients
achieved the MID in 6MWD at the end of the second course of PR. Those who
achieved the MID in 6MWD during the second course of rehabilitation also tended
to have attained greater improvement in this outcome during the first course (P =
.07). CONCLUSION: Two-thirds of patients with COPD undergoing repeat PR
experienced significant improvement in exercise capacity. Offering PR to patients
with COPD on an as-needed basis appears to be beneficial even after a prolonged
period of time between the interventions.

Langue : ANGLAIS

Tiré à part : OUI