[Favorable effects of rehabilitation in patients with CARA]

To examine the effects of a rehabilitation programme in patients with asthma or COPD who have major complaints despite the fact that their pulmonary function is not severely disturbed.

Medical Centre Dekkerswald, Groesbeek.

Prospective clinical trial.

The treated group consisted of 44 patients with an obstructive lung disease, FEV1 68.3% of predicted value. This group was compared with 43 patients in a control group. These were volunteers, who were comparable for pulmonary function, reversibility, age, sex, Quetelet index, pulmonary medication and educational level. These groups were examined for 2 years by means of tests and questionnaires. Changes from baseline values were analysed by covariance analysis. Patients followed a rehabilitation programme which consisted of an optimal medical treatment in combination with training of physical endurance, health education and psychological and social support. The duration of the programme was 3 months, 38 hours a week.

Pulmonary rehabilitation had a long-term beneficial effect on endurance, several psychological valuables, consumption of medical care, attitude towards way of life, skills, coordination and smoking habits. Bronchial hyperresponsiveness, need of pulmonary drugs and complaints of cough and sputum production did not change after rehabilitation. Airway obstruction and subjective feelings of dyspnoea, allergy and hyperresponsiveness only decreased in the short term (less than I year).

This study shows that pulmonary rehabilitation improves many variables in the short as well as in the long run. When COPD patients do not improve on conventional treatment, pulmonary rehabilitation should be considered.