Pulmonary rehabilitation is successful for COPD irrespective of MRC dyspnoea grade

R.A. Evans, R. Collier, J.E. Williams, M.D.L. Morgan, Sally J. Singh

    Research output: Contribution to journalArticle

    64 Citations (Scopus)

    Abstract

    Background It is not clear whether the benefits of pulmonary rehabilitation (PR) apply equally to patients with Chronic Obstructive Pulmonary Disease (COPD) with different levels of starting disability. We have therefore investigated the effect of pulmonary rehabilitation stratified by the MRC dyspnoea scale in patients with COPD. Methods This is a retrospective, observational study of data collected from 450 consecutive patients with COPD attending outpatient PR: 247 male, mean (SD) age 69.5 (8.9) yrs and FEV1 44.6 (19.7)% predicted. The Incremental Shuttle Walk Test (ISWT) was performed before and after the seven-week course Results 395 patients (88%) completed the programme. The mean (SD) baseline ISWT performance was 167 (113)m. The distribution of baseline MRC grades was 2 – 15.4%, 3 – 24.9%, 4 – 27.3% and 5 – 32.4%. The mean (95% CI) improvement in ISWT after PR for each MRC scale grade was highly significant (p <0.0005); 2 – 66 (50–83)m, 3 – 63 (50–75)m, 4 – 59 (49–70)m, and 5 – 54 (43–64)m. Conclusions Patients with COPD, of all MRC dyspnoea grades, benefit comparably from pulmonary rehabilitation achieving both statistically and clinically meaningful improvements in exercise performance MRC grade should therefore not be used to exclude patients from pulmonary rehabilitation.
    Original languageEnglish
    Pages (from-to)1070-1075
    JournalRespiratory Medicine
    Volume103
    Issue number7
    DOIs
    Publication statusPublished - Jul 2009

    Fingerprint

    Dyspnea
    Chronic Obstructive Pulmonary Disease
    Rehabilitation
    Lung
    Observational Studies
    Outpatients
    Retrospective Studies
    Exercise
    Walk Test

    Keywords

    • COPD
    • Pulmonary rehabilitation
    • Exercise
    • MRC dyspnoea scale
    • --------------------------------------------------------------------------------

    Cite this

    Evans, R. A., Collier, R., Williams, J. E., Morgan, M. D. L., & Singh, S. J. (2009). Pulmonary rehabilitation is successful for COPD irrespective of MRC dyspnoea grade. Respiratory Medicine, 103(7), 1070-1075. https://doi.org/10.1016/j.rmed.2009.01.009

    Pulmonary rehabilitation is successful for COPD irrespective of MRC dyspnoea grade. / Evans, R.A.; Collier, R.; Williams, J.E.; Morgan, M.D.L.; Singh, Sally J.

    In: Respiratory Medicine, Vol. 103, No. 7, 07.2009, p. 1070-1075.

    Research output: Contribution to journalArticle

    Evans, RA, Collier, R, Williams, JE, Morgan, MDL & Singh, SJ 2009, 'Pulmonary rehabilitation is successful for COPD irrespective of MRC dyspnoea grade' Respiratory Medicine, vol. 103, no. 7, pp. 1070-1075. https://doi.org/10.1016/j.rmed.2009.01.009
    Evans, R.A. ; Collier, R. ; Williams, J.E. ; Morgan, M.D.L. ; Singh, Sally J. / Pulmonary rehabilitation is successful for COPD irrespective of MRC dyspnoea grade. In: Respiratory Medicine. 2009 ; Vol. 103, No. 7. pp. 1070-1075.
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    abstract = "Background It is not clear whether the benefits of pulmonary rehabilitation (PR) apply equally to patients with Chronic Obstructive Pulmonary Disease (COPD) with different levels of starting disability. We have therefore investigated the effect of pulmonary rehabilitation stratified by the MRC dyspnoea scale in patients with COPD. Methods This is a retrospective, observational study of data collected from 450 consecutive patients with COPD attending outpatient PR: 247 male, mean (SD) age 69.5 (8.9) yrs and FEV1 44.6 (19.7){\%} predicted. The Incremental Shuttle Walk Test (ISWT) was performed before and after the seven-week course Results 395 patients (88{\%}) completed the programme. The mean (SD) baseline ISWT performance was 167 (113)m. The distribution of baseline MRC grades was 2 – 15.4{\%}, 3 – 24.9{\%}, 4 – 27.3{\%} and 5 – 32.4{\%}. The mean (95{\%} CI) improvement in ISWT after PR for each MRC scale grade was highly significant (p <0.0005); 2 – 66 (50–83)m, 3 – 63 (50–75)m, 4 – 59 (49–70)m, and 5 – 54 (43–64)m. Conclusions Patients with COPD, of all MRC dyspnoea grades, benefit comparably from pulmonary rehabilitation achieving both statistically and clinically meaningful improvements in exercise performance MRC grade should therefore not be used to exclude patients from pulmonary rehabilitation.",
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