Benefits of different intensities of pulmonary rehabilitation for patients with moderate-to-severe COPD according to the GOLD stage: a prospective, multicenter, single-blinded, randomized, controlled trial

• Main Authors: He GX, Li N, Ren L, Shen HH, Liao N, Wen JJ, Xu YM, Wang J, Li QY
• Format: Article
• Language: English
• Published: Dove Medical Press 2019-10-01
• Series: International Journal of COPD
• Subjects: Chronic obstructive pulmonary disease; Cardiopulmonary exercise testing; Exercise therapy; Pulmonary rehabilitation
• Online Access: https://www.dovepress.com/benefits-of-different-intensities-of-pulmonary-rehabilitation-for-pati-peer-reviewed-article-COPD
• ISSN: 1178-2005

Guo Xia He,1,2,* Ning Li,1,3,* Lei Ren,2,4,* Hong Hua Shen,2 Ning Liao,5 Jian Jun Wen,6 Yi Min Xu,2 Jing Wang,4 Qing Yun Li1,3 1Department of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China; 2Department of Respiratory Rehabilitation, The Fourth Rehabilitation Hospital of Shanghai (Shanghai Jingan Geriatric Hospital), Shanghai 200042, People’s Republic of China; 3Institute of Respiratory Disease, Shanghai Jiaotong University School of Medicine, Shanghai 200025, People’s Republic of China; 4Department of Respiratory Medicine, The Second Affiliated Hospital of Suzhou University, Jiangsu 215004, People’s Republic of China; 5West-Nanjing Road Community Health-care Center of Shanghai, Shanghai 200040, People’s Republic of China; 6Caojiadu Community Health Service of Shanghai, Shanghai 200042, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qing Yun LiDepartment of Pulmonary and Critical Care Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197 Ruijin 2nd Road, Shanghai 200025, People’s Republic of ChinaTel [phone]Fax [phone]Email [e-mail]: Pulmonary rehabilitation (PR) is essential to manage patients with COPD. The aim of this study was to investigate the appropriate intensity of PR exercise training for patients with moderate-to-severe COPD.Patients and methods: A prospective multicenter randomized controlled trial was conducted from January 2014 to October 2018. The subjects were randomly assigned to three groups with different intensities of PR, according to their maximum oxygen uptake percentage determined by cardiopulmonary exercise testing. After 20 weeks of exercise training, the effects of low-, moderate-, and high-intensity exercise interventions on patients were compared to determine the most appropriate PR prescription.Results: For patients with moderate COPD, all the measured parameters were significantly improved in the moderate- and high-intensity PR groups (P<0.01), while there was no significant difference in the frequency of acute exacerbations and the mMRC questionnaire after 20 weeks of PR exercise in the low-intensity PR group. For patients with severe COPD, all variables were also improved in the high-intensity PR group (P<0.05), while the mean differences of pre- and post-PR were lower than those in patients with moderate COPD. Moreover, the Hamilton Anxiety Scale and body mass index showed no significant difference in low-intensity PR group (P>0.05).Conclusion: High-intensity PR exercise is helpful for patients with moderate to severe COPD. Moderate COPD patients need to receive intensive PR training; the improvement degrees from PR intervention were higher than those of the severe COPD patients. For patients with severe COPD, high-intensity PR exercise may be more beneficial if patients can tolerate it.Keywords: chronic obstructive pulmonary disease, cardiopulmonary exercise testing, exercise therapy, pulmonary rehabilitation