Source: Annual Congress 2009 - Pulmonary rehabilitation: extending the scope and benefit of rehabilitation for patients with chronic respiratory disease
Disease area: Airway diseases

Abstract

Most international statements have recommended offering pulmonary rehabilitation (PR) to all patients who consider themselves functionally disabled by COPD (usually defined as MRC Dyspnoea Scale 3 or above). Recent data suggests that even less breathless COPD patients (MRC 1 and 2) have quadriceps weakness and reduced daily physical activity. We wished to test whether MRC Dyspnoea Scale 2 COPD patients also benefit from PR.
All MRC Dyspnoea 2 patients referred to the Lambeth & Southwark Pulmonary Rehabilitation Team between the years 2004 – 2007 were included in the study. Patients were offered PR at one of seven hospital or community programmes. Outcome measures were the incremental shuttle walk (ISW), the CRQ Dyspnoea score (CRQ–D), and the Hospital Anxiety and Depression Scale (HAD–A and HAD–D). COPD patients with MRC Dyspnoea 3 or 4 undertaking PR over the same time period acted as controls.
Results were analysed for 126 MRC 2 and 316 MRC 3 / 4 patients. At baseline, the MRC 2 group had increased exercise capacity, less dyspnoea, and reduced anxiety and depression scores. Following PR, the MRC 2 group showed similar mean improvements in ISW, both in absolute terms (83 vs. 68 metres; p=0.08) and in terms of median %improvement (27 vs. 33 %; p=0.07) as MRC 3 / 4 patients. Furthermore, mean improvements in CRQ-D (0.75 vs. 0.75), HAD–A (-1.4 vs. -1.1) and HAD– D (-1.1 vs. -1.3) were similar between the two groups (p=0.96, 0.74 and 0.46 respectively).
Although MRC Dyspnoea Scale 2 patients referred for PR have better exercise capacity and less symptoms of dyspnoea, anxiety or depression compared with MRC 3 /4 patients, they show similar improvements to pulmonary rehabilitation.

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Citations should be made in the following way:
W. Man, A. Grant, L. Moore, J. Moore, M. Polkey, R. Barker, J. Moxham (London, United Kingdom). Pulmonary rehabilitation in mrc dyspnoea scale 2 patients. Eur Respir J 2009; 34: Suppl. 53, 535

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