Mantenimiento de los efectos tras la rehabilitación pulmonar en pacientes con enfermedad pulmonar obstructiva crónica

Background/objective: The duration of the effects of pulmonary rehabilitation (PR) in patients with chronic obstructive pulmonary disease (COPD) is limited. The aim of the study was to describe the short- and long-term effects of various modalities of clinical PR programs in COPD patients and to identify possible influencing factors. Patients/methods: Retrospective longitudinal observational study was conducted on 35 COPD subjects who received one of the following PR clinical programs (8 weeks): PRP1 (endurance training), PRP2 (endurance-strength training), and PRP3 (endurance-strength-respiratory muscle training). Variables: exercise capacity (distance in the Six-Minute Walk Test, 6MWD), dyspnoea (modified Medical Research Council Scale, mMRC), and respiratory pressures (only PRP3), evaluated pre-treatment, post-treatment and post-12 months. Results: The 6MWD improved post-treatment (59.1 ± 27.3 m, P <.01) and the mMRC Scale was reduced (−0.7 ± 0.4, P < 0.01). Post−12 months after treatment there was a decline in 6MWD (−49.8 ± 23 m, P < 0.01) and an increase in mMRC Scale (0.7 ± 0.4, P < 0.01). These results were slightly higher in the PRP2 and PRP3 groups, but without significant differences (P > 0.05). A similar behaviour was observed in the respiratory pressures. An analysis was made of the possible influencing factors in the decline in 6MWD during follow−up. Only a significant and inverse correlation was found between the increase in post−treatment 6MWD and its post−12 months decline (r = −0.52, P < 0.01). Conclusion: Conventional PR programs in COPD improve exercise capacity and dyspnoea, but these benefits are lost after 12 months without maintenance. The increase in 6MWD after PR may be a prognostic factor of decline in exercise tolerance.