Pulmonary rehabilitation coupled with negative pressure ventilation decreases decline in lung function, hospitalizations, and medical cost in COPD

A 5-year study

Hung Yu Huang, Pai Chien Chou, Wen Ching Joa, Li Fei Chen, Te Fang Sheng, Horng Chyuan Lin, Lan Yan Yang, Yu Bin Pan, Fu Tsai Chung, Chun Hua Wang, Han Pin Kuo

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Pulmonary rehabilitation (PR) brings benefits to patients with chronic obstructive pulmonary disease (COPD). Negative pressure ventilation (NPV) increases ventilation and decreases hyperinflation as well as breathing work in COPD. We evaluated the long-term effects of a hospital-based PR program coupled with NPV support in patients with COPD on clinical outcomes.One hundred twenty-nine patients with COPD were followed up for more than 5 years, with the NPV group (n = 63) receiving the support of NPV (20-30 cm H2O delivery pressure for 60 min) and unsupervised home exercise program of 20 to 30 min daily walk, while the control group (n = 6) only received unsupervised home exercise program. Pulmonary function tests and 6 min walk tests (6MWT) were performed every 3 to 6 months. Emergency room (ER) visits and hospitalization with medical costs were recorded.A significant time-by-group interaction in the yearly decline of forced expiratory volume in 1 s in the control group analyzed by mixed-model repeated-measure analysis was found (P = 0.048). The 6MWT distance of the NPV group was significantly increased during the first 4 years, with the interaction of time and group (P = 0.003), the time alone (P = 0.014), and the quadratic time (P < 0.001) being significant between the 2 groups. ER exacerbations and hospitalizations decreased by 66% (P < 0.0001) and 54% (P < 0.0001) in the NPV group, respectively. Patients on PR program coupled with NPV had a significant reduction of annual medical costs (P = 0.022).Our hospital-based multidisciplinary PR coupled with NPV reduced yearly decline of lung function, exacerbations, and hospitalization rates, and improved walking distance and medical costs in patients with COPD during a 5-year observation.

Original languageEnglish
Pages (from-to)e5119
JournalMedicine
Volume95
Issue number41
DOIs
Publication statusPublished - Oct 1 2016

Fingerprint

Chronic Obstructive Pulmonary Disease
Ventilation
Hospitalization
Rehabilitation
Pressure
Costs and Cost Analysis
Lung
Hospital Emergency Service
Exercise
Work of Breathing
Control Groups
Respiratory Function Tests
Forced Expiratory Volume
Walking
Observation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pulmonary rehabilitation coupled with negative pressure ventilation decreases decline in lung function, hospitalizations, and medical cost in COPD : A 5-year study. / Huang, Hung Yu; Chou, Pai Chien; Joa, Wen Ching; Chen, Li Fei; Sheng, Te Fang; Lin, Horng Chyuan; Yang, Lan Yan; Pan, Yu Bin; Chung, Fu Tsai; Wang, Chun Hua; Kuo, Han Pin.

In: Medicine, Vol. 95, No. 41, 01.10.2016, p. e5119.

Research output: Contribution to journalArticle

Huang, Hung Yu ; Chou, Pai Chien ; Joa, Wen Ching ; Chen, Li Fei ; Sheng, Te Fang ; Lin, Horng Chyuan ; Yang, Lan Yan ; Pan, Yu Bin ; Chung, Fu Tsai ; Wang, Chun Hua ; Kuo, Han Pin. / Pulmonary rehabilitation coupled with negative pressure ventilation decreases decline in lung function, hospitalizations, and medical cost in COPD : A 5-year study. In: Medicine. 2016 ; Vol. 95, No. 41. pp. e5119.
@article{e80b3a3690f34f0dac8a0b95072c4431,
title = "Pulmonary rehabilitation coupled with negative pressure ventilation decreases decline in lung function, hospitalizations, and medical cost in COPD: A 5-year study",
abstract = "Pulmonary rehabilitation (PR) brings benefits to patients with chronic obstructive pulmonary disease (COPD). Negative pressure ventilation (NPV) increases ventilation and decreases hyperinflation as well as breathing work in COPD. We evaluated the long-term effects of a hospital-based PR program coupled with NPV support in patients with COPD on clinical outcomes.One hundred twenty-nine patients with COPD were followed up for more than 5 years, with the NPV group (n = 63) receiving the support of NPV (20-30 cm H2O delivery pressure for 60 min) and unsupervised home exercise program of 20 to 30 min daily walk, while the control group (n = 6) only received unsupervised home exercise program. Pulmonary function tests and 6 min walk tests (6MWT) were performed every 3 to 6 months. Emergency room (ER) visits and hospitalization with medical costs were recorded.A significant time-by-group interaction in the yearly decline of forced expiratory volume in 1 s in the control group analyzed by mixed-model repeated-measure analysis was found (P = 0.048). The 6MWT distance of the NPV group was significantly increased during the first 4 years, with the interaction of time and group (P = 0.003), the time alone (P = 0.014), and the quadratic time (P < 0.001) being significant between the 2 groups. ER exacerbations and hospitalizations decreased by 66{\%} (P < 0.0001) and 54{\%} (P < 0.0001) in the NPV group, respectively. Patients on PR program coupled with NPV had a significant reduction of annual medical costs (P = 0.022).Our hospital-based multidisciplinary PR coupled with NPV reduced yearly decline of lung function, exacerbations, and hospitalization rates, and improved walking distance and medical costs in patients with COPD during a 5-year observation.",
author = "Huang, {Hung Yu} and Chou, {Pai Chien} and Joa, {Wen Ching} and Chen, {Li Fei} and Sheng, {Te Fang} and Lin, {Horng Chyuan} and Yang, {Lan Yan} and Pan, {Yu Bin} and Chung, {Fu Tsai} and Wang, {Chun Hua} and Kuo, {Han Pin}",
year = "2016",
month = "10",
day = "1",
doi = "10.1097/MD.0000000000005119",
language = "English",
volume = "95",
pages = "e5119",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "41",

}

TY - JOUR

T1 - Pulmonary rehabilitation coupled with negative pressure ventilation decreases decline in lung function, hospitalizations, and medical cost in COPD

T2 - A 5-year study

AU - Huang, Hung Yu

AU - Chou, Pai Chien

AU - Joa, Wen Ching

AU - Chen, Li Fei

AU - Sheng, Te Fang

AU - Lin, Horng Chyuan

AU - Yang, Lan Yan

AU - Pan, Yu Bin

AU - Chung, Fu Tsai

AU - Wang, Chun Hua

AU - Kuo, Han Pin

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Pulmonary rehabilitation (PR) brings benefits to patients with chronic obstructive pulmonary disease (COPD). Negative pressure ventilation (NPV) increases ventilation and decreases hyperinflation as well as breathing work in COPD. We evaluated the long-term effects of a hospital-based PR program coupled with NPV support in patients with COPD on clinical outcomes.One hundred twenty-nine patients with COPD were followed up for more than 5 years, with the NPV group (n = 63) receiving the support of NPV (20-30 cm H2O delivery pressure for 60 min) and unsupervised home exercise program of 20 to 30 min daily walk, while the control group (n = 6) only received unsupervised home exercise program. Pulmonary function tests and 6 min walk tests (6MWT) were performed every 3 to 6 months. Emergency room (ER) visits and hospitalization with medical costs were recorded.A significant time-by-group interaction in the yearly decline of forced expiratory volume in 1 s in the control group analyzed by mixed-model repeated-measure analysis was found (P = 0.048). The 6MWT distance of the NPV group was significantly increased during the first 4 years, with the interaction of time and group (P = 0.003), the time alone (P = 0.014), and the quadratic time (P < 0.001) being significant between the 2 groups. ER exacerbations and hospitalizations decreased by 66% (P < 0.0001) and 54% (P < 0.0001) in the NPV group, respectively. Patients on PR program coupled with NPV had a significant reduction of annual medical costs (P = 0.022).Our hospital-based multidisciplinary PR coupled with NPV reduced yearly decline of lung function, exacerbations, and hospitalization rates, and improved walking distance and medical costs in patients with COPD during a 5-year observation.

AB - Pulmonary rehabilitation (PR) brings benefits to patients with chronic obstructive pulmonary disease (COPD). Negative pressure ventilation (NPV) increases ventilation and decreases hyperinflation as well as breathing work in COPD. We evaluated the long-term effects of a hospital-based PR program coupled with NPV support in patients with COPD on clinical outcomes.One hundred twenty-nine patients with COPD were followed up for more than 5 years, with the NPV group (n = 63) receiving the support of NPV (20-30 cm H2O delivery pressure for 60 min) and unsupervised home exercise program of 20 to 30 min daily walk, while the control group (n = 6) only received unsupervised home exercise program. Pulmonary function tests and 6 min walk tests (6MWT) were performed every 3 to 6 months. Emergency room (ER) visits and hospitalization with medical costs were recorded.A significant time-by-group interaction in the yearly decline of forced expiratory volume in 1 s in the control group analyzed by mixed-model repeated-measure analysis was found (P = 0.048). The 6MWT distance of the NPV group was significantly increased during the first 4 years, with the interaction of time and group (P = 0.003), the time alone (P = 0.014), and the quadratic time (P < 0.001) being significant between the 2 groups. ER exacerbations and hospitalizations decreased by 66% (P < 0.0001) and 54% (P < 0.0001) in the NPV group, respectively. Patients on PR program coupled with NPV had a significant reduction of annual medical costs (P = 0.022).Our hospital-based multidisciplinary PR coupled with NPV reduced yearly decline of lung function, exacerbations, and hospitalization rates, and improved walking distance and medical costs in patients with COPD during a 5-year observation.

UR - http://www.scopus.com/inward/record.url?scp=85011984527&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011984527&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000005119

DO - 10.1097/MD.0000000000005119

M3 - Article

VL - 95

SP - e5119

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 41

ER -