Home based pulmonary Rehab Plus NPPV Improves QoL in COPD Patients, confirms study
Researchers have identified in a new study that the integration of home-based pulmonary rehabilitation with non-invasive positive pressure ventilation (NPPV) improves the quality of life, lung function, and exercise capacity in patients with moderate to severe chronic obstructive pulmonary disease (COPD) to a great extent. This is following a trial comparing the effectiveness of this combined therapy (CPRNG group) with standard treatment alone (CTG group). The study was conducted by Shu Xie and colleagues published in BMC Pulmonary Medicine.
Chronic obstructive pulmonary disease (COPD) continues to be a global cause of morbidity and mortality, with the symptoms of breathlessness, tiredness, and decreased physical activity profoundly affecting day-to-day functioning. NPPV facilitates breathing by assisting airflow on inhalation and is typically applied in more severe instances to enhance oxygenation and alleviate carbon dioxide retention. Simultaneously, pulmonary rehabilitation enhances the strength of respiratory muscles, improves tolerance to exercise, and enhances the well-being of patients. This research aimed to assess whether a home-based rehabilitation program combined with NPPV would offer better outcomes in the management of COPD symptoms than conventional treatments alone.
269 patients with COPD of moderate to severe degree were included and divided into two groups: 132 patients received combined pulmonary rehabilitation and NPPV (CPRNG group), and 137 patients received conventional therapy (CTG group). Both groups were assessed with a range of standardized tools, including the COPD Assessment Test (CAT), modified Medical Research Council scale (mMRC), forced expiratory volume in 1 second (FEV₁%), 6-minute walk test, and arterial oxygen pressure (PaO₂). Patient-reported quality-of-life scores were also directed toward three domains: impact, symptoms, and activity.
Results
Early comparisons revealed no substantial differences between the groups regarding age, gender, duration of illness, or baseline symptoms, making a fair comparison possible. Following the intervention, the patients in the CPRNG group had statistically significant improvements in all primary outcomes than those in the CTG group:
CAT score: Improved substantially in CPRNG group (p = 0.028)
mMRC score: Improved symptom control (p = 0.015)
FEV₁%: Increased improvement in lung function (p = 0.008)
6-min walk distance: Enhanced exercise tolerance (p = 0.001)
PaO₂ levels: Increased oxygenation (p < 0.001)
Home pulmonary rehabilitation combined with non-invasive positive pressure ventilation greatly enhances lung function, physical performance, symptom control, and quality of life in patients with moderate to severe COPD. This combination is a useful strategy in the management of COPD, particularly in improving patient-centered outcomes like day-to-day activity and comfort.
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