Over the past three decades there have been scores of studies which demonstrate the health benefits gained by COPD patients enrolled in pulmonary rehabilitation (PR) programs. Whether reflected in improved physical conditioning, reduced symptoms, or higher levels of patient reported quality of life, the magnitude of the improvements reported in these studies are impressive considering how short in duration most of these studies evaluate patient experience (typically 6-12 weeks).
So when a group of Israeli researchers reported results of their 3-year PR study in May 2009¹ it was cause for eyes to open wide and jaws to drop – at least for me The research team of David Stav, Meir Raz and Isaac Shpirer, set out to examine whether a prolonged course of pulmonary rehabilitation would provide incremental conditioning benefits for COPD patients (you can view the full text of the study results at the following Internet Link. In my view, their results were astonishing:
153% increase in maximum sustained exertion (peak load) on a stationary ergonometer for the study group after 1 year in the PR program (rose to 160% after 3 years) compared to a 7% decline for the control group in the study (those who did not participate in PR)
110% increase in sustained time on the ergonometer at 75% of maximum peak load for the study group after 1 year compared to 0% improvement for the control group (results for both groups holding relatively constant at 3 years).
Why is this impressive? Most of the 8-12 week PR program studies that have garnered wide attention among respiratory care professionals over the past three decades show conditioning improvements that range anywhere from 10-30%. The fact that Stav and his colleagues demonstrated much larger conditioning improvements for prolonged patient participation in a PR program reinforces in my mind the substantial benefits derived from starting and maintaining a life-long commitment to PR principles and practices.
It will be interesting to see if other researchers follow in Stav, et al’s footsteps to validate/replicate these findings in subsequent prolonged PR program duration studies, but in the meantime I think there’s enough of a readily available body of evidence in shorter duration studies to conclude that pulmonary rehabilitation is a powerful treatment option for COPD patients.
¹Stav D, Raz M, Shpirer I. Three years of pulmonary rehabilitation: inhibit the decline in airflow obstruction, improves exercise endurance time, and body-mass index, in chronic obstructive pulmonary disease. BMC Pulmonary Medicine 2009, 9:26.
