Physical and affective components of dyspnea are improved by pulmonary rehabilitation in COPD

BMJ Open Respir Res. 2022 Jan;9(1):e001160. doi: 10.1136/bmjresp-2021-001160.

ABSTRACT

BACKGROUND: Dyspnea is a multidimensional experience of respiratory discomfort, but its affective dimension is rarely assessed in people with chronic obstructive pulmonary disease (COPD). We evaluated the effectiveness of a home-based pulmonary rehabilitation (PR) program on the physical and affective components of dyspnea assessed by the Dyspnoea-12 (D-12) questionnaire. We also determined the baseline characteristics that contributed to the change in D-12 scores.

METHODS: In this retrospective study, 225 people with COPD (age, 65±11 years; forced expiratory volume in 1 s (FEV₁), 35 ± 15% of predicted) were enrolled in person-centered home PR, consisting of a weekly 90-minute supervised home session for 8 weeks. Questionnaire at D-12, state of health, anxious and depressive symptoms, exercise tolerance and general fatigue were assessed on inclusion (M0), at the end of the PR program (M2), and 8 (M8) and 14 months (M14) after M0. Multivariate analysis of covariance (ANCOVA) models were performed to identify baseline characteristics that contributed to the change in D-12 scores.

RESULTS: Physical and affective components of dyspnea and all other outcome measures were improved at M2, M8 and M14 compared to baseline (p1, anxiety symptoms and exercise tolerance (6 min stepper test). However, given that these variables had only a small impact on the evolution of the D-12 questionnaire scores, the results of the ANCOVA analysis should be taken with caution.

CONCLUSION: The physical and affective components of dyspnea were improved, in the short and long term, by 8 weeks of individualized PR at home. The present results support the importance of assessing dyspnea as a multidimensional experience during PR, warranting replication through robustly designed randomized controlled studies.

PMID:35078826 | DOI: 10.1136/bmjresp-2021-001160