Abstract
Although one purpose of pulmonary rehabilitation is to enhance patients' performance, perceived difficulty in assessing functional status has discouraged its measurement as an outcome event in efficacy studies of pulmonary rehabilitation. METHODS: We sought to address this shortcoming by evaluating the efficacy of a 12-session, 6-week, comprehensive rehabilitation program in 16 patients with severe lung disease (FEV1 = 0.94±0.42 L [mean ± standard deviation]), assessing changes in spirometry, oxygen saturation, 6-minute walk distance, and functional performance as measured by three scales (Medical Research Council Index, Modified Pneumoconiosis Research Unit Score, and the Modified Dyspnea Index). RESULTS: Although no improvement in airflow or oxygen saturation occurred, mean 6-minute walk distance increased by 27%, and the rehabilitation program did confer functional benefits, as reflected by significant improvement in all three functional status scores. CONCLUSION: Pulmonary rehabilitation of patients with chronic lung disease can enhance their walking capacity and functional status as measured by the three scales. Our comparison of the scores on the three functional scales suggests that the Modified Dyspnea Index may be the most sensitive measure of changes in patients' functional status.
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