Pulmonary rehabilitation relieves COPD symptoms and improves quality of life

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Pulmonary rehabilitation programs can relieve shortness of breath and improve exercise capacity and quality of life in people with chronic obstructive pulmonary disease (COPD), according to a recent meta-analysis.

In addition, the study found that mind-body exercises, such as tai chi and yoga, can significantly improve lung function in these patients.

“Our study confirms known effects of classic PR [pulmonary rehabilitation programs]’ the researchers said, but also shows ‘that yoga and tai chi can produce significant improvement and have benefits [lung capacity measurements] which PR doesn’t do.”

The study, “Effect of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review and meta-analysis of randomized controlled trials‘ was published in the magazine Annals of Medicine.

COPD is a progressive, chronic disease characterized by persistent respiratory symptoms and airflow limitations. People with COPD often undergo pulmonary rehabilitation as part of their treatment plan. Such rehabilitation programs are often personalized and conducted according to the individual needs of the patients in order to improve their quality of life, exercise capacity and relieve shortness of breath.

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“Compared to traditional outpatient care, pulmonary rehabilitation is reduced [shortness of breath] and fatigue and improves exercise endurance and many domains of health-related quality of life (HRQOL),” the researchers wrote.

These rehabilitation programs have also been shown to reduce disease complications, increase social participation and reduce medical costs.

Previous analyzes have looked at the impact of pulmonary rehabilitation on COPD patients. However, they didn’t include mind-body exercises like yoga and tai chi when calculating results.

This meta-analysis – a study combining data from previous research – focused on evaluating the effectiveness of using such interventions, including yoga and tai chi, for COPD patients.

The investigators included 39 studies of pulmonary rehabilitation programs in 2,397 patients with COPD from around the world published between 1999 and 2020.

The analysis found that the distance walked on the 6-minute walk test (6MWT) — a walk test commonly used to assess the physical capacity of COPD patients — was lower in patients undergoing pulmonary rehabilitation compared to those who did not was significantly improved.

When the 6MWT results were broken down by subgroup, there was a significant improvement in patients who practiced yoga, tai chi, and conventional exercise.

Numerous studies have reported patient ratings on the St. George Respiratory Questionnaire (SGRQ) – a questionnaire used to assess the impact of obstructive pulmonary disease on patients’ health-related quality of life. These 25 studies showed that such rehabilitation significantly improved patients’ SGRQ scores, indicating an improvement in health-related quality of life.

Subgroup analysis showed that conventional exercise led to a significant improvement in SGQR scores, while yoga and tai chi did not.

Shortness of breath was also significantly alleviated in patients undergoing pulmonary rehabilitation, according to data from the 11 studies evaluating the results of the British Medical Research Council’s modified patient questionnaire scale.

Forced expiratory volume in one second, or FEV1, a lung function parameter that measures how much air a person can force exhale in one second – a test of lung capacity – was examined in 18 studies. Pulmonary rehabilitation programs allowed for significant changes in the FEV1% predicted value. However, when broken down by subgroup, a significant improvement in FEV1% was only seen with yoga and tai chi and not with conventional exercise.

“This meta-analysis confirmed that yoga and tai chi significantly improved predicted FEV1%. The pulmonary rehabilitation program improves physical performance, quality of life and [eases shortness of breath] in patients with COPD,” the researchers wrote.

“However, additional studies on large datasets and well-designed models are needed to support these results,” they wrote.

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