Does the Benefit from Pulmonary Rehabilitation Differ Between Phenotypes in COPD

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is a disease caused by airway and / or parenchymal pathology. Therefore, some patients inevitably have chronic bronchitis and some patients have emphysema. The responses of these most prominent major phenotypes to exercise are also thought to be different. In this study we investigated the difference of benefits from PR in chronic bronchitis and emphysema. Material and Method: Retrospective data of patients with chronic bronchitis and emphysema who completed outpatient 8-week PR program between 2013 and 2017 in the PR unit were examined. Demographic data (age, sex, body mass index, smoking history, long term oxygen therapy (LTOT), noninvasive ventilation, emergency admissions, and number of hospitalizations in the last one year were recorded. The patients were divided into two groups as chronic bronchitis and emphysema. Emphysema was radiologically defined whereas chronic bronchitis according to clinical description. Two groups compared for the recorded data. Method: Of the 146 patients, 85 were in the emphysema group and 61 were in the chronic bronchitis group. There was no difference between the two groups in terms of age and gender. Pulmonary function test (PFT) parameters (FEV1, TLCO), arterial blood gas values (pO2, pCO2, SpO2), 6 MWT, and quality of life scores were significantly improved after PR. However, there was no difference between emphysema and chronic bronchitis groups in terms of gain after PR. Conclusion: In this study, it was observed that the gain from PR in COPD patients was independent of phenotype. Therefore, all COPD patients should be encoureged to participate in PR programs regardless of their phenotypes.