Chronic obstructive pulmonary disease (COPD) is an umbrella term for diseases including emphysema and chronic bronchitis. COPD is increasing worldwide, and the World Health Organization predicts that it will be the third most common cause of death, and fifth most common cause of lost working days by 2020. COPD causes shortness of breath, which has a huge impact on daily living.
People with COPD may experience a rapid worsening of symptoms in what is called an ‘exacerbation’ or a flare-up. These are usually triggered by a chest infection and often require hospitalisation. During time in hospital, patients become weaker and even more inactive. It may take several weeks or months to recover their prior level of activity and health.
Many COPD patients are treated with an exercise-based programme called ‘pulmonary rehabilitation’ to maximise their lung health and capability for physical activity. However, it is not known whether pulmonary rehab is useful in helping COPD patients to recover from an exacerbation. During the study, Professor Moxham and his team investigated this.
They recruited 60 patients who were admitted to hospital with a COPD exacerbation. Half received usual care and the other half received additional pulmonary rehab. All patients were monitored for three months to see how well they did. Thirty-three per cent of those treated with usual care ended up back in hospital with another exacerbation, compared to only 7 per cent of the pulmonary rehab group. The pulmonary rehab group also showed better muscle strength, better performance in a walking test and superior quality of life.
This study has shown that pulmonary rehabilitation is not only a successful tool for helping to maintain quality of life in COPD, but that it is also a vital tool in helping people recover from a COPD exacerbation. Crucially, this provides the scientific evidence needed for this practice to be safely recommended to all COPD patients.
Professor Moxham is Medical Director of King’s College Hospital NHS Foundation Trust and Professor of Respiratory Medicine in the School of Medicine.
His specialist interests include COPD, pulmonary rehabilitation, breathlessness and respiratory muscle weakness. As well as respiratory medicine, he is also a general physician responsible for acute medical admissions
