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Title: The Impact of Pulmonary Rehabilitation on Chronic Pain in People with COPD.
Austin Authors: Lee, Annemarie L;Butler, Stacey J;Varadi, Robert G;Goldstein, Roger S;Brooks, Dina
Affiliation: Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
Department of Medicine, University of Toronto, Toronto, Ontario, Canada
School of Rehabilitation Sciences, McMaster University, Hamilton, Ontario, Canada
Department of Physiotherapy, Monash University, Frankston, Victoria, Australia
Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Cabrini Health, Malvern, Victoria, Australia
Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, Ontario, Canada
Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
Issue Date: Apr-2020
Date: 2020-03-05
Publication information: COPD 2020; 17(2): 165-174
Abstract: Chronic pain affects up to 88% of people with chronic obstructive pulmonary disease (COPD) and has been associated with comorbidities. However, with pain not evaluated during pulmonary rehabilitation (PR) assessments, it is unclear whether PR impacts pain intensity and coping ability. This study aimed to 1) determine the effect of PR on pain qualities, coping behavior and psychological symptoms in those with COPD and chronic pain; and 2) assess the impact of PR on exercise capacity and quality of life in individuals with COPD and chronic pain compared to those without pain. Patients with COPD and comorbidities enrolling in outpatient PR were assessed for chronic pain. Those with chronic pain completed the Brief Pain Inventory, Coping Strategies Questionnaire-24, Fear Avoidance Behavior Questionnaire and measures of anxiety and depression. Changes in HRQOL and 6-minute walk distance (6MWD) following PR were compared between participants with and without chronic pain. Thirty-four participants with chronic pain and 34 participants without pain were included (mean ± SD, FEV1 47 ± 19% predicted). In those with chronic pain, PR did not affect pain intensity (median[IQR] pre/post PR 3[2-5] vs. 4[2-6] points, p = 0.21), anxiety (7[2-9] vs. 5[3-8] points, p = 0.82) or depression (4[2-8] vs. 3[1-6] points, p = 0.38) and did not change pain coping strategies. Both groups improved in 6MWD (mean difference [95% CI] 17[-39 to 72] m), and those without pain had greater improvement in mastery (p = 0.013). PR was effective in patients with moderate to severe COPD whether or not they reported chronic pain at the time of their initial assessment.
DOI: 10.1080/15412555.2020.1733952
ORCID: 0000-0001-6080-5052
Journal: COPD
PubMed URL: 32131643
Type: Journal Article
Subjects: Pulmonary rehabilitation
chronic obstructive pulmonary disease
chronic pain
Appears in Collections:Journal articles

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