How effective is pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease (COPD)?
Treatment group assignment was not blinded in these studies. This may have introduced bias for subjective outcomes, such as quality of life, but is less likely to be an important source of bias for mortality and hospital admission data. Another limitation is the small number of patients included in the trials and methodological shortcomings.
Pulmonary rehabilitation has become a cornerstone in the management of patients with stable COPD. Systematic reviews have shown large and important clinical effects of pulmonary rehabilitation in these patients. In patients with unstable COPD who have suffered from an exacerbation recently, however, the effects of pulmonary rehabilitation are less established.