Chest
Volume 100, Issue 3, September 1991, Pages 613-617
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Clinical Investigations
Psychological Outcomes of a Pulmonary Rehabilitation Program

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This study assessed physiologic, psychological, and cognitive functioning in outpatients with COPD. Sixty-four subjects, 53 to 82 years of age, participated in the 30-day exercise rehabilitation program. The program consisted of exercise, education and psychosocial counselling. Participants were assessed prior to beginning the program and at the end of 30 days. Assessments at both times included physiologic functioning (bicycle ergometry testing, pulmonary function tests, 12-min walk), psychological well-being (anxiety, depression, psychiatric symptoms, perceived well-being) and an abbreviated neuropsychological test battery. Results indicate significant improvement in physical endurance and pulmonary function, significant reductions in symptoms of depression and anxiety, and improvement in measures of general well-being and neuropsychological functioning. The study suggests that exercise rehabilitation of older adults with COPD contributes not only to improvements in physical functioning and endurance, but also to enhanced cognitive functioning and psychological well-being.

(Chest 1991; 100:613-17)

Section snippets

Subjects

The study included 64 older adults who volunteered to participate in an outpatient pulmonary rehabilitation program at Duke University Medical Center. Criteria for inclusion in the study were: (1) age =50 years, (2) symptoms for more than six months, and (3) the ***FEV1/FVC ratio <0.70. Participants ranged in age from 53 to 82 years (mean = 67.4 ± 7.0 years), and were approximately evenly distributed by gender (35 male [55 percent], 29 female [45 percent]).

Exercise Rehabilitation Program

Participants attended the program in

Adherence

Of the 64 subjects assessed at time 1, 61 subjects (95 percent) completed the 30-day program. Two females and one male dropped out, leaving 34 males and 27 females with complete data.

Pulmonary Function

Changes in pulmonary function were tested in a MANOVA of three variables: FVC, FEV1 and MVV. The MANOVA indicated a gender main effect (F[3,56] = 14.08, p<0.001) and time main effect (F[3,57] = 10.05, p<0.001), but no interaction effect. Univariate testing indicated that all three measures of pulmonary function

DISCUSSION

These data suggest the efficacy of exercise rehabilitation among both male and female older adults with COPD. Participants in the 30-day exercise rehabilitation program achieved significant improvement in pulmonary function, physical endurance and functional capacity. In addition, participants experienced enhanced psychological well-being, as indicated by reduced affective distress and improved cognitive functioning.

The greater functional and work capacity among males as opposed to females is

ACKNOWLEDGMENTS

The authors wish to thank Pamela Allison-Goretzky, Michelle Feldman and LeeAnn Robinson for technical assistance and Janet Ivey for secretarial assistance.

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Manuscript received October 15; revision accepted December 13

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