Key result
8-week pulmonary rehab improves ADLs in COPD, reducing metabolic load, dyspnea, and completion time.
Why the study?
A high proportion of patients with COPD experience problems during activities of daily living, motivating evaluation of how pulmonary rehabilitation affects physiologic responses to and performance of ADLs.
Does an 8-week pulmonary rehabilitation program improve the physiologic response to and performance of ADLs in patients with COPD?
Does an 8-week pulmonary rehabilitation program improve the physiologic response to and performance of ADLs in patients with COPD?
An 8-week comprehensive pulmonary rehabilitation program improves the physiologic response and reduces the time and symptoms associated with activities of daily living in patients with COPD.
May support pulmonary rehabilitation to ease ADLs in COPD; leaves open confirmation by randomized trials before practice change.
A high proportion of patients with chronic obstructive pulmonary disease (COPD) experience problems during the performance of activities of daily living (ADLs). We aimed to determine the effects of a comprehensive 8-wk pulmonary rehabilitation program on the physiologic response to and performance of ADLs in patients with COPD. Before and after pulmonary rehabilitation, 31 patients with COPD [71% men; mean age: 64.2 (SD 8.4) years; mean forced expiratory volume in the first second: 54.6 (SD 19.9) % predicted] performed physical function tests, the Canadian Occupational Performance Measure (COPM), and an ADL test consisting of the following: putting on socks, shoes, and vest; stair climbing; washing up four dishes, cups, and saucers; doing groceries and putting away groceries in a cupboard; folding eight towels; and vacuum cleaning for 4 min. Metabolic load, ventilation, and dynamic hyperinflation were assessed using an Oxycon mobile device. In addition, symptoms of dyspnea and fatigue and time to complete ADLs were recorded. After rehabilitation, patients with COPD used a significantly lower proportion of their peak aerobic capacity and ventilation to perform ADLs, accompanied by lower Borg scores for dyspnea and fatigue. Furthermore, patients needed significantly less time to complete ADLs. Dynamic hyperinflation occurred during the performance of ADLs, which did not change following pulmonary rehabilitation. Changes in physical function, including six-min walk distance, constant work rate test, quadriceps muscle strength, and COPM were significantly correlated with change in average total oxygen uptake during the performance of the ADL test. A comprehensive pulmonary rehabilitation program can improve the physiologic response to and actual performance of ADLs in patients with COPD. NEW & NOTEWORTHY A high proportion of patients with chronic obstructive pulmonary disease (COPD) experience problems during the performance of activities of daily living (ADLs). This study clearly demonstrated that a comprehensive pulmonary rehabilitation program can improve the performance of ADLs in patients with COPD, indicated by a significantly shorter time to perform ADLs and a lower metabolic load and dyspnea sensation.
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Vaes et al. (2018) studied chronic obstructive pulmonary disease (COPD) (n=31). Comprehensive pulmonary rehabilitation program vs. Pre-rehabilitation baseline was evaluated on Physiologic response to and performance of activities of daily living (ADLs). An 8-week comprehensive pulmonary rehabilitation program significantly improved activities of daily living in patients with COPD, reducing metabolic load, dyspnea, and completion time.
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