The Efficacy of Personalized Pulmonary Rehabilitation Programs on Recovery Outcomes in COPD Patients During Acute Exacerbations

Summary

After personalized pulmonary rehabilitation in 200 patients with chronic obstructive pulmonary disease (COPD), the rehabilitation outcomes were assessed using standardized rating scales and composite scores, and the results demonstrated significant clinical efficacy.

Abstract

Pulmonary rehabilitation (PR) is a core component of chronic obstructive pulmonary disease (COPD) management; however, its implementation during acute exacerbations remains variable, particularly with respect to individualized approaches. This study aimed to evaluate the association between inpatient personalized PR and recovery-related clinical outcomes in hospitalized patients with acute exacerbations of COPD (AECOPD). A single-center retrospective cohort study was conducted at a tertiary care hospital between January 2021 and June 2024. Hospitalized patients aged ≥40 years with spirometry-confirmed COPD who experienced AECOPD and completed an inpatient personalized PR program were included. The rehabilitation program was initiated within 48–72 h of clinical stabilization and tailored based on baseline symptom burden, functional capacity, dyspnea severity, oxygen saturation, and exercise tolerance. Primary outcomes included changes in the COPD assessment test (CAT), modified medical research council (mMRC) dyspnea scale, and 6-minute walk test (6MWT) distance from baseline to program completion. Secondary outcomes included length of hospital stay and 30-day readmission rates. A total of 200 patients were included in the analysis. Mean CAT scores decreased from 25.4 ± 4.6 at baseline to 17.2 ± 3.8 following rehabilitation (p < 0.001). Mean mMRC dyspnea scores improved from 3.1 ± 0.8 to 2.0 ± 0.7 (p < 0.001). Functional exercise capacity increased, with the mean 6MWT distance improving from 210 ± 68 m to 310 ± 75 m (p < 0.001). The average length of hospital stay was reduced from 10.5 ± 3.2 days to 6.3 ± 2.1 days (p < 0.001), and 30-day readmission rates decreased from 25% to 10% (p < 0.001). In this retrospective cohort, inpatient personalized PR implemented during AECOPD was associated with improvements in symptom burden, dyspnea severity, functional exercise capacity, and selected healthcare utilization outcomes.

Introduction

Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by persistent airflow limitation and chronic respiratory symptoms, most commonly resulting from long-term exposure to noxious particles or gases, particularly cigarette smoke. COPD encompasses chronic bronchitis and emphysema and is associated with substantial morbidity, impaired functional capacity, and reduced health-related quality of life. Acute exacerbations of COPD (AECOPD) are defined by an acute worsening of respiratory symptoms such as dyspnea, cough, and sputum production, often requiring hospitalization. These events play a critical role in the natural history o....

Protocol

Obtained ethical approval for this retrospective study from the Institutional Ethics Committee of TongDe Hospital of Zhejiang Province (Approval No.: 2024-268-JY). Conducted all procedures in accordance with the ethical standards of the institutional research committee and the principles of the Declaration of Helsinki. Waived the requirement for written informed consent due to the retrospective nature of the study and the use of anonymized clinical data, as approved by the ethics committee.

1. Study design

1. Identify patients hospitalized with acute exacerbations of COPD between January 2021 and June 2024. Include....

Results

Baseline characteristics
Two hundred acutely ill patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) were enrolled to do the final analysis. The average age of the participating population was 68.5 with a standard deviation of 8.3, in the age bracket between middle-aged and elderly adults. Male left ventricular systolic dysfunction patients comprised 60% (n = 120) and female patients 40% (n = 80). The baseline demographic and clinical features are presente.......

Discussion

In this retrospective cohort study, the evaluations included the feasibility and clinical effects of modified PR used in the AECOPD during hospitalization and for the purpose of this study in acute exacerbation management. The results suggest that personalized rehabilitation should be launched at the acute stage, which is associated with a substantial increase in the symptom burden, severity of dyspnea, functional exercise capability, and chosen healthcare use outcomes. Notably, the size of the improvement of the primary.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Elliptical/cross-training machine	Technogym	D9573	Equipped with Technogym Live console, with networking function
Treadmill	Technogym	Live 500	It features a touch screen, strong shock absorption and speed/slope adjustment performance
Upright Bike	Life Fitness	LFISRUBC	It is suitable for scenarios in hospital physical rehabilitation centers where both durability and comfort are required.