Effect of Pulmonary Rehabilitation on Exercise Tolerance in COPD Patients: Randomized Controlled Trial

Abstract

Background:

Chronic obstructive pulmonary disease is a progressive respiratory disorder associated with reduced exercise tolerance, persistent dyspnea, and impaired functional capacity. These limitations contribute to decreased physical activity and poor quality of life, even in patients receiving optimal pharmacological treatment. Pulmonary rehabilitation is recognized as an effective non-pharmacological intervention, yet locally generated evidence from South Punjab remains limited.

Objective:

To determine the effect of pulmonary rehabilitation on exercise tolerance in patients with chronic obstructive pulmonary disease.

Methods:

A randomized controlled trial was conducted at tertiary care hospitals and rehabilitation centers in Multan, South Punjab, between May and December 2022. Sixty patients with stable moderate to severe chronic obstructive pulmonary disease were randomly allocated to either a pulmonary rehabilitation group or a usual care group. The pulmonary rehabilitation program was delivered three times per week for eight weeks and included supervised aerobic training, strengthening exercises, breathing exercises, and patient education. Exercise tolerance was assessed using the Six-Minute Walk Test. Secondary outcomes included dyspnea measured by the Modified Borg Dyspnea Scale and functional health status assessed using the COPD Assessment Test. Data were analyzed using paired and independent sample t-tests, assuming normal distribution.

Results:

The pulmonary rehabilitation group demonstrated a significant improvement in six-minute walk distance, with a mean increase of 79.7 meters, compared with a 21.2-meter improvement in the usual care group (p = 0.002). Dyspnea scores and COPD Assessment Test scores also improved significantly in the rehabilitation group, with greater reductions observed compared to usual care (p < 0.01). A higher proportion of patients in the rehabilitation group achieved clinically meaningful improvements in exercise tolerance and symptom burden.

Conclusion:

Pulmonary rehabilitation significantly improved exercise tolerance and reduced symptom burden in patients with chronic obstructive pulmonary disease. These findings support the integration of structured pulmonary rehabilitation programs into routine cardiorespiratory physiotherapy services in South Punjab.

Keywords:

Chronic Obstructive Pulmonary Disease, Dyspnea, Exercise Tolerance, Pulmonary Rehabilitation, Quality of Life, Six-Minute Walk Test, Physiotherapy