Pulmonary rehabilitation improves depression, anxiety, dyspnea and health status in patients with COPD

OBJECTIVE: To determine the impact of an 8-wk program of comprehensive pulmonary rehabilitation on depression, anxiety, dyspnea, and health-related quality of life in patients with chronic obstructive pulmonary disease (COPD). DESIGN: We studied 24 patients with severe COPD randomized either to pulmonary rehabilitation (PR), (n = 10; FEV1 30 +/- 9%) or control (C; n = 14; FEV1 34 +/- 11%). The PR program included disease education, energy conservation techniques, relaxation, and exercise including 20-min arm elevation with dumbbells and 20-min leg exercise sessions three times a week for 8 wks. At baseline and after completion of the program, all patients were evaluated using the Beck Depression Inventory, State Trait Anxiety Inventory (STAI), Modified Medical Research Council Scale (MRC), and St. George's Respiratory Questionnaire (SGRQ). RESULTS: After PR, there was a significant improvement in the severity of depression (P < 0.01), a decrease in symptoms (P < 0.05), an increase in daily living activities (P < 0.05), and a decrease in the total score of the SGRO (P < 0.01). Dyspnea measured by the MRC scale was significantly better in the PR group (P < 0.01). CONCLUSIONS: The present study shows that in patients with severe COPD, pulmonary rehabilitation induces important changes on depression and anxiety independent of changes in dyspnea and health-related quality-of-life.