Seven-year time course of lung function, symptoms, health-related quality of life, and exercise tolerance in COPD patients undergoing pulmonary rehabilitation programs

Aim: To evaluate the long-term course of outcome indexes in patients with chronic obstructive pulmonary disease (COPD) undergoing repeated pulmonary rehabilitation programs (PRP). Design: Prospective, observational study. Setting: Pulmonary Rehabilitation Center. Patients: Forty-eight COPD patients (M 33, age 59.6±8.9 years, forced expiratory volume in 1 s (FEV₁) 58±16% predicted, DLCO 71±17% predicted.) undergoing 5 Day-Hospital based PRPs in a period of 7.2±0.8 years. Measurements: Lung function, exercise capacity (incremental cycloergometry, test-6-minute walking test (6MWD)), dyspnoea (Baseline-BDI and Transitional-TDI Dyspnoea Index and Medical Research Council score-MRC), health-related quality of life (HRQL) (St. George Respiratory Questionnaire (SGRQ), and the derived BODE index were assessed pre and post each PRP. Results: During follow-up, patients showed a 18±22 (mean±SEM) ml/year FEV₁ decline (95%CI: -24.4 to 11.6; p1. Each PRP elicited significant improvement in exercise capacity, dyspnoea, SGRQ and BODE score. Post-PRP improvements in 6MWD, MRC and TDI were higher after the first three than after the last two PRPs (p