Efficacy of inpatient pulmonary rehabilitation in elderly patients with acute exacerbation of COPD: randomised controlled trial study

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide. Data on Acute exacerbation of COPD (AECOPD) among older adults is scarce. The study aims to assess the impact of early initiation of pulmonary rehabilitation (PR) during hospitalization on exercise capacity, dyspnea, sleep quality, fatigue, and the length of hospital stay in patients with AECOPD. A single-blind randomised controlled trial. The study took place in the Chest Diseases Department at Alzahraa University Hospital, Cairo, Egypt, between June and September 2025. Subject: 60 patients completed the study, randomised into two equal groups. Group of pulmonary rehabilitation (PR) and control group each included 30patients with a ratio of 1:1. There were notable significant differences between groups; the PR group showed more improvement in walking distance measured by the 6-minute walk distance (6MWD), fatigue, sleep quality, dyspnea, and patients spent less time in the hospital. Our analysis found that fatigue and dyspnea were closely linked and central to patients’ experiences. Dyspnea was a stronger predictor of functional capacity than forced expiratory volume at 1st second (FEV1). Overall, these findings demonstrate that inpatient PR is effective in improving outcomes and physical performance while reducing healthcare utilization in elderly patients with AECOPD.