• Mara BALTEANU Marius Nasta” National Institute of Pneumophtysiology, Bucharest
  • C. KAMAL University of Medicine and Pharmacy Craiova
  • Diana KAMAL “Elga” Polyclinic, Craiova
  • Paraschiva POSTOLACHE “Grigore T. Popa” University of Medicine and Pharmacy Iasi
  • Rodica TRAISTARU University of Medicine and Pharmacy Craiova


PULMONARY REHABILITATION IN COPD PATIENTS-OBSERVATIONAL STUDY (Abstract): The aim was to analyze the effects of an 8-week pulmonary rehabilitation (PR) program on quality of life (QoL), physical performance (6MWD value - six-minute walk test) and pulmonary function in patients with mild and moderate COPD.  Material and methods: 23 subjects with COPD with FEV1≥50% were assigned to a clinic treatment group (n=12) or a home exercise group (n=11). Subjects in the first group received supervised exercise program over a 6-week period after 2 weeks inpatient PR program. Subjects in the second group received the same exercise program initially in hospital, followed by 6 weeks of home exercises, reinforced by a clinic visit at 2 weeks. Measured outcomes were the 6MWD, the generic QoL scale St. George’s Respiratory Questionnaire Disease (SCRQ) and statistical analysis by ANOVA test. Results: Both groups showed clinically and statistically significant improvements in 6MWD and SCRQ scores at 8 weeks; improvements were still evident in both groups at 3 months. By 8 weeks, SGRQ scores had improved in both groups with 28% and 24%; 6 MWD had improved with 13% and 5%, and important differences were observed in the mean changes of 6MWD: 56.42 m in the first group, 17.7 m in the second group. At 3 months, the results of both groups were substantially and about equally improved over baseline measurements. Conclusions: Subjects in the first group were more satisfied with the overall outcome of their rehabilitation treatment compared with subjects in the second group.

Author Biographies

C. KAMAL, University of Medicine and Pharmacy Craiova

Faculty of Medicine

Paraschiva POSTOLACHE, “Grigore T. Popa” University of Medicine and Pharmacy Iasi

Faculty of Medicine
Department of Medical Specialties (I)
Rehabilitation Clinical Hospital, Iasi

Rodica TRAISTARU, University of Medicine and Pharmacy Craiova

Faculty of Medicine


1. ***GOLD 2017: Global Strategy for the Diagnosis, Management and Prevention of COPD. https://goldcopd.org/gold-2017-global-strategy-diagnosis-management-prevention-copd/
2. Rochester CL, Vogiatzis I, Anne E, et al. An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med 2015; 192(11): 1373-1386.
3. Celli BR, Decramer M, Wedzicha JA, et al. An Official American Thoracic Society/European Res-piratory Society Statement: Research Questions in Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2015; 191(7): e4-e27.
4. Nemes RM, Duceac LD, Vasincu EG, Agop M, Postolache P. On the Implications of the Biological Systems Fractal Morpho-Functional Structure. U.P.B. Sci.Bull., Series A 2015; 77(4): 263-272.
5. Postolache P, Duceac LD, Vasincu EG, Agop M, Nemeş RM. Chaos and self-structuring behaviors in lung airways. U.P.B. Sci.Bull., Series A 2016; 78(1): 291-298.
6. Postolache P, Nemes RM, Croitoru A, Constantin B. The Role of Pulmonary Rehabilitation in Occu-pational COPD. JEPE 2015; 16(2): 521-527.
7. O’Reilly J, Jones MM, Parnham J, et al. Guideline Development Group. Management of stable chronic obstructive pulmonary disease in primary and secondary care: summary of updated NICE guidance. BMJ 2010; 340: c3134.
8. Celli BR, MacNee W, Agusti A, et al. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004; 23: 932-946.
9. Qaseem A, Wilt T, et al. Diagnosis and Management of Stable Chronic Obstructive Pulmonary Dis-ease: A Clinical Practice Guideline Update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med 2011; 155: 179-191.
10. Spruit MA, Singh SJ, Garvey C, et al. An Official American Thoracic Society/European Respiratory Society Statement: Key Concepts and Advances in Pulmonary Rehabilitation. Am J Respir Crit Care Med 2013; 188 (8): e13-e64.
11. Nici L, Donner C, Wouters E, et al. American Thoraic Society/European Respiratory Society Statement on pulmonary rehabilitation. Am J Respir Crit Care Med 2006; 173: 1390-1413.
12. Effing T, Monninkhof EM, van der Valk PDea. Self-management education for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2007; (4):CD002990.
13. Postolache P, Cozma CD, Cojocaru DC. Assessment of Nicotine Dependence in a Large Cohort of Smokers - Social and Medical Aspects. Rev of Res and Soc Interv 2013; 41: 106-117.
14. Traistaru R, Marcu R, Popescu R. Exercise performance in chronic bronchial asthmatic patients. J of Rehab Med 2008; 40(Suppl. 47): 180-181.
15. Murphy K, Casey D, Devane D, et al. A cluster randomized controlled trial evaluating the effectiveness of a structured pulmonary rehabilitation education programme for improving the health status of people with chronic obstructive pulmonary disease (COPD): The PRINCE Study Protocol. BMC Pulm Med 2011; http://www.biomedcentral.com/1471-2466/11/4.
16. Bestall J, Paul E, Garrod R, Garnham R, Jones P, Wedzicha J. Usefulness of the Medical Research Council (MRC) dyspnea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999; 54: 581-586.
17. ***ATS statement: guidelines for the six-minute walk test. Am J Crit Care Med 2002; 166: 111-117.
18. Postolache P, Cojocaru DC. Pulmonary rehabilitation-from guidelines to practice. Rev Med Chir Soc Med Nat, Iasi 2013; 117(2): 380-387.
19. Traistaru R, Popescu-Hagen M, Nitu M, Ardelean D, Postolache P. Pulmonary Rehabilitation and Quality of Life in Elderly Females with COPD. Chest 2014; 146(4): 541 A
20. Popescu-Hagen M, Traistaru R, Marica C, Rogoveanu O, Tanasescu M, Postolache P. An Eight Week Pulmonary Rehabilitation in COPD Patients: Observational Study. Chest 2014; 146(4): 541 A.
21. Jones P, Quirk F, Baveystock C. The St. George’s Respiratory Questionnaire. Respir Med 1991; 85: 25-31.
22. Jones P, St. George’s Respiratory Questionnaire: MCID. COPD 2005; 2: 75-79.
23. Stav D, Raz M, Spirer I. Three years of pulmonary rehabilitation: inhibit the decline in airflow ob-struction, improves exercise endurance time, and body-mass index, in chronic obstructive pulmonary disease. BMC Pulm Med 2006; 9: 26.
24. Bianchi R, Gigliotti F, Romagnoli I, et al. Impact of a rehabilitation Program on Dyspnea Intensity and Quality in Patients with Chronic Obstructive Pulmonary Disease. Respiration 2011; 81: 186-195.
25. Areias V, Ferreira D, Martins A, et al. Evolution of functional capacity and health status 2 years after a Pulmonary Rehabilitation Program. Rev Port Pneumol 2012; 18(5): 217-225.
26. Crisafulli E, Gorgone P, Vagaggini B, et al. Efficacy of standard rehabilitation in COPD outpatients with comorbidities. Eur Respir J 2010; 36:1042-1048.
27. Bolton CE, BevanSmith EF, Blakey JD, et al. British Thoracic Society guideline on pulmonary reha-bilitation in adults. Thorax 2013; 68: ii1-ii30.
28. Ståhl E, Lindberg A, Jansson S, et al. Health-related quality of life is related to COPD disease severity. Health and Quality of Life Outcomes 2005; 3: 56.
29. Rossi G, Florini F, Romagnoli M, et al. Length and Clinical Effectiveness of Pulmonary Rehabilitation in Outpatients with Chronic Airway Obstruction. CHEST 2005; 127:105-109.
30. Pitta F, Takaki MY, Oliveira NH, et al. Relationship between pulmonary function and physical activity in daily life in patients with COPD. Resp Med 2008, 102: 1203-1207.
31. Watz H, Waschki B, Meyer T, Magnussen H. Physical activity in patients with COPD. Eur Respir J 2009; 33: 262-272.
32. Fisher M, Abbink J, Rudolphus A, et al. Participation and drop-out in pulmonary rehabilitation quali-tative analysis of the patient’s perspective. Clin Rehabil 2007; 21: 212-221.
33. Heppner P, Morgan C, Ries A. Regular walking and long-term maintenance of outcomes after pul-monary rehabilitation. J Cardiopulm Rehabil 2006; 26: 44-53.
34. Spencer L, Alison J, McKeoug Z. Maintaining benefits following pulmonary rehabilitation: a ran-domized controlled trial. Eur Respir J 2010; 35: 571-577.
35. Brooks D, Krip B, Mangovski-Alzamora, Goldstein R. The effect of post rehabilitation programmes among individuals with chronic obstructive pulmonary disease. Eur Respir J 2002; 20: 20-29.
36. Weldam M, et al. Perceived quality of life in chronic obstructive pulmonary disease patients: a cross-sectional study in primary care on the role of illness perceptions. BMC Family Practice 2014; 15: 140, http://www.biomedcentral.com/1471-2296/15/140.
37. Jones PW, Brusselle G, Dal Negro RW, Ferrer M, Kardos P, Levy ML, Perez T, Soler-Cataluña JJ, van der Molen T, Adamek L, Banik N. Health-related quality of life in patients by COPD severity within primary care in Europe. Respir Med 2011; 105(1): 57-66.