Understanding the Impact of Pulmonary Rehabilitation on Airway Resistance in Patients with Severe COPD: A Single-Center Retrospective Study

• Published in: International journal of chronic obstructive pulmonary disease Vol. 18; pp. 1 - 10
• Main Authors: Kiliç, Lütfiye, Tural Önür, Seda, Gorek Dilektasli, Aslı, Ulubay, Gaye, Balcı, Arif
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2023; Dove Medical Press Ltd; Dove; Dove Medical Press
• Subjects: airflow limitation; Airway Resistance; body plethysmography; Care and treatment; Chronic obstructive pulmonary disease; Dyspnea; Emphysema; Exercise; Female; Forced Expiratory Volume; Hospitals; Humans; Lung; Lung diseases; Lung diseases, Obstructive; lung mechanics; Male; Mechanics; Medical research; Medicine, Experimental; Original Research; Oxygen saturation; Patients; Performance evaluation; Physical fitness; Physiology; Pulmonary Disease, Chronic Obstructive; Pulmonary Emphysema - diagnosis; Rehabilitation; Retrospective Studies; Statistical analysis; Thoracic surgery; United States > US; airflow limitation; body plethysmography; airway resistance; lung mechanics; emphysema
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S384127

We investigated the effect of pulmonary rehabilitation (PR) on airway resistance in chronic obstructive pulmonary disease (COPD) patients with severe airway obstruction and hyperinflation. This retrospective cohort study was conducted with data from severe COPD cases with those who underwent an 8-week PR program. Main inclusion criteria were having severe airflow obstruction (defined as a forced expiratory volume in one second (FEV ) <50%) and plethysmographic evaluation findings being compatible with hyperinflation supporting the diagnosis of emphysema (presence of hyperinflation defined as functional residual capacity ratio of residual volume to total lung capacity (RV/TLC) >120%). Primary outcomes were airway resistance (R ) and airway conductance (G ) which were measured by body plethysmography, and other measurements were performed, including 6-minute walk test (6-MWT), modified Medical Research Council dyspnea scale (mMRC) and COPD assessment test (CAT). Twenty-six severe and very severe COPD patients (FEV 35.0 ± 13.1%; RV/TLC, 163.5 ± 29.4) were included in the analyses, mean age 62.6 ± 5.8 years and 88.5% males. Following rehabilitation, significant improvements in total specific airway resistance percentage (sR %, p = 0.040) and total specific airway conductance percentage (sG %; p = 0.010) were observed. The post-rehabilitation mMRC scores and CAT values were significantly decreased compared to baseline results (p < 0.001 and p < 0.001, respectively). Although there were significant improvements in 6-MWT value (p < 0.001), exercise desaturation (ΔSaO , p = 0.026), the changes in measured lung capacity and volume values were not significant. We concluded that PR may have a positive effect on airway resistance and airway conductance in COPD patients with severe airflow obstruction.