Lung rehab boosts exercise capacity for COPD patients, study finds

Respiratory rehabilitation is safe and can help improve exercise capacity in people with chronic obstructive pulmonary disease (COPD) with or without pulmonary hypertension (PH), a study reported.

A rehab program “demonstrated effectiveness in improving [exercise capacity] for COPD patients, regardless of the echocardiographic probability of PH,” the researchers wrote. “Tolerance was also comparable between the two groups, with no significant differences in the occurrence of exacerbations or course interruptions.”

The study, “Effectiveness and tolerance of respiratory rehabilitation in suspected pulmonary hypertension associated with chronic obstructive pulmonary disease,” was published in Respiratory Medicine and Research.

COPD is an inflammatory lung disease that causes the airways to become blocked. PH, or abnormally high pressure in the vessels that carry blood from the heart through the lungs, is a common complication of COPD.

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Respiratory rehabilitation broadly refers to exercise programs and other interventions that aim to improve the lungs’ ability to take in oxygen. This type of rehab is generally recommended for people with COPD, but there isn’t much published data on whether respiratory rehabilitation is safe and effective in people with COPD who have co-occurring PH.

To learn more, researchers analyzed data from 59 COPD patients who underwent a respiratory rehabilitation program at a center in France. Based on echocardiography (a type of heart imaging), 11 of the patients had suspected PH, while the remaining 48 did not.

To evaluate the effectiveness of the rehabilitation program, the researchers used a measure called the six-minute walk distance (6MWD). This measure, which tracks how far someone can walk in six minutes, is commonly used to evaluate exercise capacity in people who are able to walk.

Following the respiratory rehabilitation program, the average 6MWD improved by an average of 75 m (246 feet) in the COPD patients with PH. Among the patients who did not have PH, the average 6MWD improved by 33 m (108 feet). The difference between the groups was not statistically significant, meaning that, mathematically, there’s a high probability that any difference is due to random chance.

Other measures, such as the proportion of patients who achieved a clinically significant improvement on the 6MWD, were also not significantly different in patients with or without PH. And in both groups, the respiratory rehabilitation program was well tolerated, with low rates of rehab interruptions or COPD exacerbations (disease flares in which lung function suddenly worsens).

The researchers concluded that their study “showed significant improvement in the 6MWD after [respiratory rehabilitation] in each group, without any significant difference in the improvement of 6MWD between the two groups and with no significant difference in the proportion of patients reaching a minimum clinically significant change in 6MWD after [respiratory rehabilitation] in either group.”

They stressed that although echocardiography was used as a proxy to measure likelihood of PH, the patients generally did not undergo the type of invasive testing required to definitively diagnose PH. They said that while more study is needed to verify and expand on the results, their data suggest that respiratory rehabilitation may offer benefits to COPD patients irrespective of PH status.