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Factors in Maintaining Long-term Improvements in Health-related Quality of Life after Pulmonary Rehabilitation for COPD

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Abstract

The purpose of this study was to reveal predictors for the long-term effects of pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) patients, in terms of health-related quality of life (HRQoL). We investigated the long-term effects of pulmonary rehabilitation in 53 COPD patients who had completed the outpatient program and could be evaluated continuously for 1 year. We also investigated factors related to long-term maintenance of HRQoL assessed by the St George’s Respiratory Questionnaire (SGRQ). In the year following the program, the only items that retained a significant improvement compared with the pre-program levels were respiratory muscle strength and 6-min walking distance. Patients whose total SGRQ score showed improvements that were maintained above the minimal clinically important difference were placed in a maintained-improvements group (n=18, 34.0%), and the others in a non-maintained group (n=35, 66.0%). A comparison of the groups revealed that the maintained-improvements group had significantly lower forced vital capacity (FVC), inspiratory capacity (IC), and tidal volume (TV) at rest; higher PaCO2; greater initial impairments in HRQoL; and more frequent attendance in a maintenance program. In a multiple logistic regression model, only PaCO2 was identified as predictor for the maintenance of improvement in HRQoL over a long term. In conclusion, higher baseline PaCO2 is predictor of maintained, long-term improvement in HRQoL after pulmonary rehabilitation. Frequent attendance in a maintenance program is another predictor.

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Nishiyama, O., Taniguchi, H., Kondoh, Y. et al. Factors in Maintaining Long-term Improvements in Health-related Quality of Life after Pulmonary Rehabilitation for COPD. Qual Life Res 14, 2315–2321 (2005). https://doi.org/10.1007/s11136-005-7710-y

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