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Submitted: 16 May 2007 Modified: 23 January 2013
HERDIN Record #: PCHRDPC960227

Reduction of dyspnea in patients with chronic obstructive pulmonary disease.

Ma. Flordeliza Sanchez ,
Melissa Viado ,
Ma. Encarnita Blanco ,
Percival Punzal

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In developed countries, pulmonary rehabilitation programs for patients with Chronic Obstructive Pulmonary Disease (COPD) are established means of enhancing standard medical therapy in order to alleviate shortness of breath and improve the physical function of patients with chronic lung diseases. A structured form of pulmonary rehabilitation program was established by the Philippine Heart Center to achieve this end in our local set up. Fifty-one patients with COPD who guaranteed from the eight-week out-patient rehabilitation program were included in the study. The patients had moderate to severe airway obstruction and reduced exercise tolerance. After competing the comprehensive education and exercise training program involving the upper and lower extremities (upper cycle ergometer, supervised treadmill and home walking programs), there was a significant improvement in terms of reduction of dyspnea and increased exercise tolerance. The pre and post rehabilitation six minute walk test showed a significant increase in the distance (in meters) covered (p 0.001). Likewise, there was also an increase of maximum workload (in MFTs) tolerated during the incremental exercise testing done at the post rehabilitation period (p 0.001). Statistical analysis of the scores from the modified Borg scale used to gauge breathlessness and fatigue post exercise testing did not significantly increase (p 0.05) despite the increase in workload tolerated after completing the program. Utilizing a standardized form of Shortness of Breath Questionnaire (Scores 1-4 denoting increasing severity of dyspnea in the performance of daily activities. After completing the program significant improvements were noted in daily activities like walking on level ground and stair climbing (p 0.001). Fear and anxiety was also significantly decreased (p 0.001). This study showed that a multidisciplinary pulmonary rehabilitation program in the Philippine setting has a very significant role in reducing breathlessness that can lead to improvement of functional capacity and enhancement of the "quality of life" of patients with COPD.

Publication Type
Publication Sub Type
Journal Article, Original
Journal of the Philippine Medical Association
Publication Date
July-September 1995
LocationLocation CodeAvailable FormatAvailability
Philippine Council for Health Research and Development Library Fulltext Print Format (Request Document)
1. "American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease and asthma" Am Respir Dis 136, 225-44, 1987
2. "American Thoracic Society. Pulmonary Rehabilitation" Am Rev Respir Dis 124, 663-66, 1981
3. Hodgkin, JE , Balchum, OJ , Kass, I , Galser, EM , Miller, P , Petty, TL . "Chronic airway diseases: current concepts in diagnosis and comprehensive care" JAMA 232, 1243-60, 1975
4. Hodgkin, JE , Zom, EG , Connor, GL Ieds) . "Pulmonary rehabilitation-guidelines to success. Boston: Butterworth Publishers" , 1984
5. Hodgkin, JE . "Pulmonary Rehabilitation: Structure components and benefits" J Cardiopulmonary Rehab 11, 423-434, 1988
6. Kimbel, P , Kaplan, AS , Alkalay, I , Lester, D . "An in-hospital program for rehabilitation of patients with chronic obstructive pulmonary disease" Chest 60, 69-109, 1971
7. Lerztman, MM , Chemiack, RM . "Rehabilitation of patients with chronic obstructive pulmonary disease" Am Rev Respir Dis 114, 1145-65, 1976
8. "make BJ (ed): Pulmonary Rehabilitation" Clin Chest Med 7, 519-32, 1986
9. Moser, KM , Bokinsky, GE , Savage, RT , Archibald, CG , Hansen, PR . "Results of a comprehensive rehabilitation program: Physiologic and functional effects on patients with chronic obstructive pulmonary disease" Arch Intern Med 140, 1596-1601, 1980
10. Morris, JF , Koski, A , Johnson, LC . "Spirometric standards for health non smoking adults" Am Rev Respir Dis 119, 831-38, 1979
11. "Borg GAV. Psychophysical bases of perceived exertion" Med Sc Sports Exer 14, 377-81, 1982
12. Guyatt, GH , Thompson, PJ , Berman, LB . "How should we measure fucntion in patients with chronic heart and lung diseases?" J Chronic Dis 38, 517-24, 1985
13. "UC san Diego Medical Center-Pulmonary rehabilitation in "Shortness of Breath Questionnaire" revised" , 1990
14. Jones, NL , Kearon, MC . "Symptoms of limiting activity in chronic airflow obstruction" Am Rev Respir Dis 139, A319, 1989
15. Sweeter, L , Zwillich, C . "Dyspnea in the patient with chronic obstructive pulmonary disease" Clinics in Chest Medicine 11, 417-45, 1990
16. Moser, KM , Ries, AL . "The art of better breathing and coughing. Shortness of breath 4th edition Mosby year book" , 43-46, 1991
17. Mahler, DA , Rosiello, RA . "Comparison of clinical dyspnea rating and psychophysical measurements of respiratory sensation in obstructive airway disease." Am Rev Respir Dis 135, 1229-33, 1987
18. Killan, KJ . "The objective measurement of breathlessness" Chest 88, 849-909, 1985
19. Chester, EH , Belman, MJ , Ghaler, RC . "Multidiscipline treatment in chronic pulmonary insifficiency: The effect of physical training of cardiopulmonary performance in patients with chronic obstructive disease" Chest 72, 695-702, 1977
20. Cockcroft, , Sanders, MJ , Berry, G . "Randomized controlled of rehabilitation in chronic respiratory disability" Thorax 198(36): 200-3,
21. Fishman, DG , Petty, TL . "Physical symptomatic and psychologic improvement in patients receiving comprehensive care of chronic airway obstriction" J Chronic Dis 24, 755-85, 1871
22. Hughes, RL , Davidson, R . "Limitations of exercise reconditioning COLD" Chest 83, 241-49,
23. Carter, RN , Nictora, B , Clark, L , Williams, J , Fields, S . "exercise conditioning in the rehabilitation of patients with chronic obstructive pulmonary disease" Arch Phys Med Rehabil 69, 11822, 1988
24. Holle, RHO , Williams, DV , Vandree, JC , Starks, GL . "Increase muscel efficiency and sustained benefits in an out-patient community hospital based pulmonary rehabilitation program" Chest 94, 1161-68, 1988