Estimating the effectiveness of pulmonary rehabilitation for different severity of COPD, ILD and IPF

Rationale: We can determine the submaximal exercise tolerance of the patients by the 6 minute walking distance (6MWD). The CAT (COPD Assessment Test) gives a comprehensive view of the quality of life, and the mMRC (modified Medical Research Council) represents the functional impairment caused by dyspnea. Materials and Methods: 470 COPD patients participated in this study, 52 grade I (males/females: 22/30, age: 67±9 years, FEV1: 89±16 ref%, BMI: 27±5 kg/m2), 118 grade II (males/females: 60/58, age: 66±8 years, FEV1: 61±8 ref%, BMI: 31±8 kg/m2), 195 grade III (males/females: 97/98, age: 63±8 years, FEV1: 39±6 ref%, BMI: 27±6 kg/m2) and 105 grade IV (males/females: 56/49, age: 62±8 years, FEV1: 24±4 ref%, BMI: 22±4 kg/m2). 28 patients with IPF (males/females: 14/14, age: 60±9 years, FVC: 55±22 ref%, BMI:26±5 kg/m2) and 40 patients with ILD (males/females: 22/18, age: 59±12 years, FVC: 67±21 ref%, BMI: 26±6 kg/m2) were also participated. Patients performed pulmonary rehabilitation (PR) for 3 weeks. Spirometry, 6MWD, CAT and mMRC at the onset and the end of the rehabilitation were recorded. We compared the change of the different groups. Results: Rehabilitation resulted improvement by different amount in different severity of COPD groups and ILD (grade I COPD 6MWD 11%, mMRC 25%, CAT 32%, grade II 6MWD 15%, mMRC 30%, CAT 34%, grade III 6MWD 16%, mMRC 30%, CAT 31%, grade IV 6MWD 18%, mMRC 22%, CAT 27%, ILD 8%, mMRC 19%, CAT 18% and IPF 6MWD 19%, mMRC 12%, CAT 14%. Conclusion: We need to focus different range of improvement in grade I-IV COPD, ILD and IPF groups in terms of 6MWD, CAT and mMRC to evaluate the effectiveness of the PR program.