Frail COPD Patients Benefit from Pulmonary Rehabilitation, Study Reveals

Researchers at King’s College London, in collaboration with several other U.K. institutions, found that pulmonary rehabilitation is helpful for frail patients with chronic obstructive pulmonary disease (COPD).

Findings from the study “Physical frailty and pulmonary rehabilitation in COPD: a prospective cohort study,” were published in the journal Thorax.

COPD, an umbrella term for several progressive pulmonary diseases characterized by inflamed and obstructed airways that eventually make breathing extremely difficult, is often accompanied by physical frailty. About 10% of people age 65 and older with frailty associated with COPD experience eventual disability, injurious falls and hospitalization. In some cases, frailty has been blamed for deadly accidents.

Because pulmonary rehabilitation aims to improve several health issues such as breathlessness, fatigue, muscle weakness, and physical inactivity, researchers maintained that the same rehabilitation might also be helpful to manage or even reverse and frailty.

In the study, researchers investigated the influence of pulmonary rehabilitation on frailty among COPD patients.
Dr. Matthew Maddocks, first author of the study based out of the Cicely Saunders Institute at King’s College, said frailty effects one in 10 people over age 65 and and one in four people over age 80 – but the combined therapy of exercise training and education could help.

“Although pulmonary rehabilitation is aimed at people with respiratory problems, it involves working the arms and legs to strengthen the muscles, and uses walking and cycling to improve fitness and balance. This model could be adapted to benefit older adults in other healthcare settings,” Maddocks said in a press release.

The study consisted of 816 COPD patients who averaged age 70 from November 2011 through January 2015. Researchers used weight loss, exhaustion, low physical activity, slowness, and weakness as criteria to measure frailty before and after pulmonary rehabilitation. The team then compared data between those who were not able to complete the rehabilitation program and those who completed it. Further analysis was completed by age and sex.

The results revealed that among all participants, 209 patients were found to suffer from sustained frailty. Largely, the inability to improve came with older patients who also struggled with other illnesses, caused them to drop from the program.

On the other hand, patients who were frail and completed the eight-week rehabilitation program were found to have better rehabilitation results. In fact, the majority of frail participants who completed the rehabilitation program were removed from frailty status.

“Although COPD is primarily a lung disease, many organ systems can be affected, contributing to the syndrome of frailty,” said senior author William Man, of the Royal Brompton & Harefield NHS Foundation Trust. “(The study) stresses the importance of a holistic approach and how interventions such as exercise training can bring great benefits to people with lung disease without necessarily treating the lungs.”

References:
www.mdspiro.com
http://lungdiseasenews.com/2016/06/16/pulmonary-rehabilitation-found-beneficial-for-frail-patients-with-copd/
http://www.kcl.ac.uk/index.aspx 
http://thorax.bmj.com/content/early/2016/06/06/thoraxjnl-2016-208460.full 
http://www.kcl.ac.uk/newsevents/news/newsrecords/2016/06%20June/Reverse-frailty-through-rehabiliation.aspx