Effect of multidimensional pulmonary rehabilitation on pulmonary functional measures exercise capacity and HRQOL of patients with COPD

Abstract

Chronic obstructive pulmonary disease (COPD) has become increasingly important cause of morbidity and mortality in the modern world. Globally about 2.9 millions adults die each year due to COPD and it ranks 5th cause of mortality world wide. In India respiratory dysfunction continues to be a major health problem, since a complex mix of socioeconomic and environmental factors such as poverty, malnutrition, illiteracy and air pollution, is prevalent. Pulmonary rehabilitation (PR) is an increasingly popular and effective option widely used for patients with moderate to severe COPD as a therapy. Although pulmonary function generally does not change, exercise tolerance can improve, together with decreased symptoms of breathlessness, improved quality of life and less need for health care services. PR combines exercise training, behavioral and educational programmes designed to help patients with COPD to control symptoms and improve day to day activities. The aim of this experimental study is to evaluate the effect of multidimensional pulmonary rehabilitation (PR) on pulmonary functional measures, six minutes walking distance (6MWD) and health related quality of life(HRQOL) of patients with COPD. Randomized controlled trail of multiple group design was adopted for this study. A total of 165 patients with COPD were randomly assigned to three groups namely control, exercise and exercise with psychosocial support group. Each group consisted of 55 patients and the duration of the study was eight weeks. Education on disease pathology, signs and symptoms, risk factors and their avoidance with the specific emphasise on smoking cessation, coping strategies, balanced diet, necessary life style modifications and adherence to the health practices was given to all the patients in order to equilibrate them at the start of the study. The demonstration of breathing and physical (Upper and Lower Extremities) exercises was performed to the exercise group and exercise with psychosocial support group.