Abstract

Fifty-nine patients with severe chronic obstructive pulmonary disease (COPD) performed pulmonary function and exercise tests before and after participation in a 12-day pulmonary rehabilitation inpatient program. Postdischarge follow-ups were performed at three months. Training consisted of twice daily aerobic exercise of 30 to 40 minutes duration. Intensity of training was determined after exercise testing and approached the maximal limits of ventilation. In general, the program failed to demonstrate significant changes in pulmonary function. Exceptions were mid-expiratory flow rate (FEF 25-75) and peak flow rate. Evaluation of exercise capacity via maximal exercise testing yielded significant increases in caloric expenditure, peak exercise oxygen consumption, and work output. Peak exercise ventilation increased significantly due to an increase in tidal volume. Work efficiency improved with training, but the change was not statistically significant. Resting oxygen consumption and carbon dioxide production were decreased; tidal volume was increased. However, the significant increase noted in tidal volume did not alter minute ventilation. In general, the changes noted at 12 days were maintained at three months postdischarge. These data support the hypothesis that a short-term, inhospital program of general exercise conditioning can improve work output, gas exchange, and mechanical efficiency without significantly affecting spirometric indices. These changes may translate into improved performance of activities of daily living and a sense of general well-being. Verf.-Referat-