Factor Analysis of Quality of Life, Dyspnea, and Physiologic Variables in Patients with Chronic Obstructive Pulmonary Disease Before and After Rehabilitation

Abstract

QOL, as evaluated by a generic questionnaire and the clinical state of patients with COPD, was independent; this independence characterized the pathophysiologic condition of our patients. Our results reinforce the usefulness of different types of evaluation, especially pre- and postrehabilitation, because they reflect independent benefits used to understand the success and follow-up of rehabilitative programs.

Predictors of changes in sick leave in workers with asthma: a follow-up study

“…This is in accordance with findings in previous studies, in which health complaints and functional limitations rather than pulmonary function measures were associated with work disability (Blanc et al 1993(Blanc et al , 1996Balder et al 1998;Erickson and Kirking 2002). The discrepancy between pulmonary function and functional limitations has been confirmed earlier (Wolkove et al 1989;Fuchs-Climent et al 2001), and recognised by the World Health Organisation, who distinguishes between impairment (airway obstruction), disability (capacity to perform activities), and participation problems (capacity to participate in daily life) (World Health Organisation 2001). OR odds ratio, CI confidence interval, R 2 percentage of explained variance, OR>1 associated with an increase in sick leave, OR<1 associated with stable low sick leave Another predictor was a lower level of education.…”

A randomised 2 × 2 trial of community versus hospital pulmonary rehabilitation, followed by telephone or conventional follow-up

“…4 , 5 The American Thoracic Society (ATS)/European Respiratory Society (ERS) statement on pulmonary rehabilitation notes that: 'Pulmonary rehabilitation is a service that complies with the general definition of rehabilitation and achieves its therapeutic aims through a permanent alteration of lifestyle.' 6 We and others wondered whether community rehabilitation would not only enhance adherence to exercise programmes by facilitating ease and convenience of participation, but also enhance its efficacy by linking it effectively to a lifestyle change rather than being a treatment that others apply in a hospital. 7,8 This theme of moving services to community settings where possible has been adopted as official policy in the UK.…”

“…6 The importance of critically examining costeffectiveness is illustrated by the finding that intensive self-management plans (which are being increasingly adopted) may not in fact be cost-effective. 54 Given that long-term effects of pulmonary rehabilitation are likely to rely on behavioural changes with some overlap with selfmanagement programmes, this urges caution.…”

“…Although the disease is defined in terms of a test of respiratory function, the FEV 1 (3), this measure actually correlates quite poorly with both quality of life and exercise capacity (6). Often, there is a loss of muscle mass and evidence of detraining (7).…”

Towards individualised treatment in COPD

“…The choice of variables can however affect the outcome and so it is not immune to a priori assumptions. Use of factor analysis has provided evidence for measures of obstruction,7–9 hyperinflation,7 exercise tolerance,7 10 airway hyper-responsiveness or bronchodilator reversibility,9 inflammation,9 11 dyspnoea and health-related quality of life7 8 12 as independent components of COPD phenotypes.…”