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Differential Pulmonary Rehabilitation Outcomes in Patients With and Without COPD: ROLE OF GENDER

Nguyen, Lam-Phuong DO; Beck, Emily MD; Cayetano, Katherine MD; Li, Chin-Shang PhD; Hardin, Kimberly MD

Journal of Cardiopulmonary Rehabilitation and Prevention: September 2017 - Volume 37 - Issue 5 - p 350–355
doi: 10.1097/HCR.0000000000000275
Pulmonary Rehabilitation
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Purpose: Individuals with all forms of pulmonary disease are referred for pulmonary rehabilitation. This study examines pulmonary rehabilitation outcomes between individuals with chronic obstructive lung disease (COPD) and non-COPD disease and the impact of gender.

Methods: This is a retrospective study at a tertiary center. The primary endpoint was the difference in 6-min walk test distance. Secondary measurements included treadmill and NuStep minutes; biceps curls and front arm raises load; quality of life measured by the St George's Respiratory Questionnaire; and University of California San Diego-Shortness of Breath Questionnaire (UCSD-SOBQ) scores.

Results: Eighty patients were included: 38 men (23 COPD, 15 non-COPD) and 42 women (31 COPD, 11 non-COPD). There was a statistically significant improvement in 6-min walk test distances pre- to post–pulmonary rehabilitation for all participants, P = .0003. Although both the COPD and non-COPD groups demonstrated overall improvement (P < .0004 and P = .02, respectively), subgroup analysis showed no statistically significant change in the non-COPD group when divided by gender. There was a significant statistical improvement in lower and upper extremity strength in all participants. Only women with COPD showed a statistically significant improvement with respect to overall quality of life as measured by St. George's Respiratory Questionnaire (P = .01). Women showed significant improvement in their depression score, as well as a trend toward improvement in the University of California San Diego-Shortness of Breath Questionnaire, while only men with COPD showed any improvement in their sleep quality measured by the Pittsburgh Sleep Quality Index.

Conclusions: Pulmonary rehabilitation results in different but improved outcomes regardless of gender or disease state.

Today, individuals with all forms of pulmonary disease are referred for pulmonary rehabilitation (PR). Our study examines PR outcomes between individuals with COPD and non-COPD disease and the impact of gender. Results demonstrated that PR is beneficial regardless of gender or disease state, although with different outcome parameters.

Departments of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine (Drs Nguyen, Beck, Cayetano, and Hardin) and Biostatistics (Dr Li), University of California, Davis; and VA Northern California Health Care System, Sacramento VA Medical Center, Mather (Drs Nguyen, Beck, Cayetano, and Hardin).

Correspondence: Lam-Phuong Nguyen, DO, UC Davis Medical Center, 4150 V St, PSSB Ste 3100, Sacramento, CA 95817 (lptnguyen@ucdavis.edu).

The authors declare no conflicts of interest.

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