• Michele Vitacca, Mara Paneroni, Beatrice Salvi, Antonio Spanevello, Piero Ceriana, Claudio Bruschi, Bruno Balbi, Maria Aliani, and Nicolino Ambrosino.
• Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS Lumezzane, Via Mazzini, 129, Brescia 25065, Italy. Electronic address: michele.vitacca@icsmaugeri.it.
• Eur. J. Intern. Med. 2023 Jan 1; 107: 818581-85.

BackgroundIndividuals with COPD may be staged according to symptoms and exacerbation history (GOLD groups: A-D) and on airflow obstruction (GOLD grades: 1-4). Guidelines recommend pulmonary rehabilitation (PR) for these individuals, including those recovering from an exacerbation (ECOPD) OBJECTIVE: To evaluate whether in individuals with clinically severe COPD, recovering from an ECOPD, the effect size of an in-hospital PR program would be affected by airflow severity grades and assessed outcome measures.MethodsRetrospective, multicentre study. Participants were compared according to different GOLD airflow grades. In addition to the MRC dyspnoea scale, six-minute walking distance test and COPD assessment test (CAT), Barthel dyspnoea index (Bid), and Short Physical Performance Battery (SPPB) were assessed, evaluating the proportion of individuals reaching the minimum clinically important difference (MCID) (responders).ResultsData of 479 individuals, completing the program were evaluated. Most of the participants were allocated in GOLD grades 4, (57.6%) and 3 (22.1%). All outcome measures significantly improved after PR (p < 0.05), without any significant difference in the proportion of responders in any measure.Conclusionsin individuals with severe COPD, recovering from ECOPD the success rate of PR does not depend on airflow severity, or outcome measure assessed. In addition to the most used outcome measures, also Bid and SPPB are sensitive to PR.Copyright © 2022 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

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