Impact of modified pulmonary rehabilitation on morbidity due to chronic obstructive pulmonary disease in rural area

Background: Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease which leads to a significant reduction in the quality of life of patients. Pulmonary rehabilitation (PR) is a multidisciplinary intervention to improve the quality of life of COPD patients. In our study, we have tried to see the effect of modified PR program to improve the quality of life in COPD patients of rural area with limited resources. Objective: The aim of this study was to study the effect of modified PR on the lung functions and quality of life of COPD patients. Materials and Methods: It was an analytical and interventional study where 30 patients of COPD were included. The total duration of study was of 12 weeks which was divided in two phases. The first phase (pharmacotherapy-[PT] Phase) comprises 6 weeks when patients were given only PT as per the Global Initiative for chronic obstructive lung disease guidelines, and subsequent phase (PT plus PR phase) comprises the next 6 weeks when patients were provided PT plus modified PR which included once a week supervised chest physiotherapy at hospital, dietary advice, and psychiatric evaluation followed by the same advice at home and were checked through the telephone weekly. Between the two phases, the severity of dyspnea (COPD assessment test [CAT] score and Modified Medical Research Council [MMRC] grade), quality of life (Saint George questionnaires [SGRQs]), psychological aspects (Patient Health Questionnaire 9 [PHQ9]), and lung functions (spirometry – forced expiratory volume in 1 s [FEV1], forced vital capacity [FVC], and FEV1/FVC) and exercise capacity (6-min walk test [6MWT]) were compared and analyzed. Results: We found a significant improvement after PR in SGRQ (P ≤ 0.001), CAT score (P ≤ 0.001), MMRC grade (P ≤ 0.001), PHQ9 score (P ≤ 0.001), and 6MWT (P ≤ 0.001) but no statistical significant improvement in spirometry parameters. Conclusion: Modified home-based PR program can be an effective therapy to improve quality of life of COPD patients in rural areas with limited resources.