Is the repeated pulmonary rehabilitation program as effective as the first one in COPD patients?

Introduction: Although it is known that the effects of pulmonary rehabilitation (PR) programs in patients with chronic obstructive pulmonary disease (COPD) decrease over time, the results of the repeat PR programs are contradictory. Our study aimed to compare the effectiveness of the initial and the repeat PR programs on functional outcomes in COPD patients.

Materials and methods: Thirty two COPD patients who completed a second PR program were included in our retrospective cohort study. Eight-week PR program was applied to the patients twice with at least a one-year interval in between. mMRC Dyspnea Scale, Six-Minute Walk Test, Hospital Anxiety and Depression Scale, 36 Item Short Form Survey (SF-36), and St. George's Respiratory Questionnaire (SGRQ) were performed before and after both programs. The gains from the initial and the repeated programs were compared.

Result: Six-minute walk distance, dyspnea, and quality of life improved following both programs (p<0.05). Improvements in six-minute walk distance (p= 0.009), dyspnea (p= 0.003), and SGRQ quality of life (p= 0.037 for activity score, p= 0.050 for total score) were found to be significantly higher in the initial PR program.

Conclusions: Although many of the gains obtained from the repeated PR programs were similar to the initial PR program, the improvements in walk distance, perception of dyspnea, and quality of life obtained in the initial PR program were higher compared to the repeated PR program.