You are not logged in. Press here to login.

Content

List volumes - List articles in this issue

Original report

Should we exclude elderly patients with chronic obstructive pulmonary disease from a long-time ambulatory pulmonary rehabilitation programme?

doi: 10.2340/16501977-0973

Open access

Abstract:

OBJECTIVE: To assess the outcomes of a 6-month comprehensive multidisciplinary outpatient pulmonary rehabilitation programme in patients with chronic obstructive pulmonary disease according to age.
DESIGN: Prospective cohort study.
Patients: A total of 140 patients with chronic obstructive pulmonary disease (Global Initiative for Chronic Obstructive Lung Disease (GOLD) 3–4) admitted to our centre for pulmonary rehabilitation.
METHODS: Patients were divided into 3 groups: group A (< 65 years), group B (65–74 years) and group C (≥ 75 years). All the patients received an education and individualized training programme. Pulmonary rehabilitation efficacy was evaluated at 6 months of treatment and 12 months post-treatment.
RESULTS: A total of 116 patients completed the pulmonary rehabilitation programme: 59 in group A (85.5%), 40 in group B (80%) and 17 in group C (80.9%). All the parameters studied (number of sessions, 6-min walking distance, isometric quadriceps strength, health-related quality of life, maximal load, peak oxygen uptake, maximal inspiratory and expiratory pressures) were significantly improved in each of the groups at 3 and 6 months compared with baseline. Moreover, percentage changes from baseline at 6 months for all of the parameters studied were not significantly different between age-groups.
CONCLUSION: Pulmonary rehabilitation is efficient in elderly patients with severe and very severe chronic obstructive pulmonary disease, and their compliance with pulmonary rehabilitation was similar to that seen in younger groups. Therefore, elderly patients with chronic obstructive pulmonary disease should not be denied pulmonary rehabilitation.

Authors:

Jean-Louis Corhay, Delphine Nguyen , Bernard Duysinx , Cédric Graas , Freddy Pirnay , Thierry Bury , Renaud Louis

References

  1. Murray CJ, Lopez AD. Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study. Lancet 1997; 349: 1498–1504.
  2. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease – 2006 [Internet]. [accessed updated December 2009]. Available from: http://www.goldcopd.com.
  3. Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, et al. Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based clinical practice guidelines. Chest 2007; 131: 4S–42S.
  4. Troosters T, Casaburi R, Gosselink R, Decramer M. Pulmonary rehabilitation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2005; 172: 19–38.
  5. Nici L, Donner C, Wouters E, Zuwallack R, Ambrosino N, Bourbeau J, et al. American Thoracic Society/European Respiratory Society. Statement on pulmonary rehabilitation. Am J Respir Crit Care Med 2006; 173: 1390–1413.
  6. Webster JR, Kadah H. Unique aspects of respiratory disease in the aged. Geriatrics 1991; 46: 31–43.
  7. Chaulker RB, Celli BR. Special considerations in the elderly patient. Clin Chest Med 1993; 14: 437–452.
  8. Couser JI Jr, Guthmann R, Hamadeh MA, Kane CS. Pulmonary rehabilitation improves exercise capacity in older elderly patients with COPD. Chest 1995; 107: 730–734.
  9. Katsura H, Kanemaru A, Yamada K, Motegi T, Wakabayashi R, Kida K. Long-term effectiveness of an inpatient pulmonary rehabilitation program for elderly COPD patients: comparison between young-elderly and old-elderly groups. Respirology 2004; 9: 230–236.
  10. Di Meo F, Pedone C, Lubich S, Pizzoli C, Traballesi M, Incalzi RA. Age does not hamper the response to pulmonary rehabilitation of COPD patients. Age Ageing 2008; 37: 530–535.
  11. Roomi J, Johnson MM, Waters K, Yohannes A, Helm A, Connolly MJ. Respiratory rehabilitation, exercise capacity and quality of life in chronic airways disease in old age. Age Ageing 1996; 25: 12–16.
  12. Charlson ME, Pompei P, Ales K, MacKenzie CR: a new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 1987, 40: 373–383.
  13. Soriano JB, Vestbo J, Pride NB, Kiri V, Maden C, Maier WC. Survival in COPD patients after regular use of fluticasone propionate and salmeterol in general practice. Eur Respir J 2002; 20: 819–825.
  14. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced expiratory flows. Eur Respir J 1993; Suppl 16: 5–40.
  15. Guyatt GH, Pugsley SO, Sullivan MJ, Thompson PJ, Berman L, Jones NL, et al. Effect of encouragement on walking test performance. Thorax 1984; 39: 818–822.
  16. Redelmeier DA, Bayoumi AM, Goldstein R, Guyatt G. Interpreting small differences in functionnal status: the six minute walk test in chronic lung disease patients. Am J Respir Crit Care Med 1997; 155: 1278–1282.
  17. Black LF, Hyatt RE,. Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Dis 1969; 99: 696–702.
  18. American Thoracic Society/American College of Chest Physicians. ATS/ACCP Statement on Cardiopulmonary Exercise Testing. Am J Respir Crit Care Med 2003; 167: 211–277.
  19. Guyatt GH, Berman LB, Townsend M, Pugsley SO, Chambers LW. A measure of quality of life for clinical trials in chronic lung disease. Thorax 1987; 42: 773–778.
  20. Bourbeau J, Maltais F, Rouleau M, Guimont C. French-Canadian version of the Chronic Respiratory and St George’s Respiratory questionnaires: an assessment of their psychometric properties in patients with chronic obstructive pulmonary disease. Can Respir J 2004; 11: 480–486.
  21. Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials 1989; 10: 407–415.
  22. Güell R, Casan P, Belda J, Sangenis M, Morante F, Guyatt GH, et al. Long-term effects of outpatient rehabilitation of COPD: a randomized trial. Chest 2000; 117: 976–983.
  23. Engstrom CP, Persson LO, Larsson S, Sullivan M. Long-term effects of a pulmonary rehabilitation programme in outpatients with chronic obstructive pulmonary disease: a randomized controlled study. Scand J Rehabil Med 1999; 31: 207–213.
  24. Troosters Th, Gosselink R, Decramer M. Short- and long-term effects of outpatient rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Am J Med 2000; 109: 207–212.
  25. Cambach W, Chadwick-Straver RV, Wagenaar RC, van Keimpema AR, Kemper HC. The effects of a community-based pulmonary rehabilitation programme on exercise tolerance and quality of life: a randomized controlled trial. Eur Respir J 1997; 10: 104–113.
  26. Güell R, Resqueti V, Sangenis M, Morante F, Martorell B, Casan P, et al. Impact of pulmonary rehabilitation on psychosocial morbidity in patients with severe COPD. Chest 2006; 129: 899–904.
  27. ZuWallack RL. Selection criteria and outcome assessment in pulmonary rehabilitation. Monaldi Arch Chest Dis 1998; 53: 429–437.
  28. Sneed NV, Paul SC. Readiness for behavioral changes in patients with heart failure. Am J Crit Care 2003; 12: 444–453.
  29. Holland AE, Hill CJ, Rasekaba T, Lee A, Naughton MT, McDonald CF. Updating the minimal important difference for six-minute walk distance in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 2010; 91: 221–225.
  30. Corriveau ML, Rosen BJ, Dolan GF. Exercise capacity following pulmonary rehabilitation in the elderly. Mo Med 1989; 86:751–756.
  31. Lacasse Y, Goldstein R, Lasserson TJ, Martin S. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2006: CD003793.
  32. Orr R, Raymond J, Fiatarone Singh M. Efficacy of progressive resistance training on balance performance in older adults: a systematic review of randomized controlled trials. Sports Med 2008; 38: 317–343.
  33. Buchman AS, Boyle PA, Leurgans SE, Evans DA, Bennett DA. Pulmonary function, muscle strength, and incident mobility disability in elders. Proc Am Thorac Soc 2009; 6: 581–587.
  34. Engstrom CP, Persson LO, Larsson S, Sullivan M. Long-term effects of a pulmonary rehabilitation programme in outpatients with chronic obstructive pulmonary disease: a randomized controlled study. Scand J Rehabil Med 1999; 31: 207–213.


Related articles

There are no related articles.


Actions


Abstract

Full text

PDF

Supplementary


There is no supplementary for this article.

Related articles


Click here to show related articles

Print information


Volume 44, Issue 5

DOI: 10.2340/16501977-0973

Pages: 466-472

View at PubMed