[en] AIM: To evaluate the effects of a pulmonary rehabilitation program (PRP) - carried out on COPD patients with exacerbations - on Health Related Quality of Life (HRQoL), exercise tolerance, illness prognosis and exacerbation´s impact. MATERIAL AND METHOS: Quasi-experimental study. 31 patients with COPD degrees III – IV and 2,4±1,5 exacerbations by patient and year underwent a 7 weeks PRP consisting of muscular training and no formal education. The main outcome measures were specific HRQoL questionnaires (St. Georges Respiratory Questionnaire (SGRQ), Chronic Respiratory Questionnaire (CRQ) and Airways Questionnaire 20 (AQ20)), six minute walking test (6MWT), and the BODE index. Exacerbations during the year post PRP were estimated by interview and clinical history review. RESULTS: All patients improved significantly (p<.001) and with clinical relevance their HRQoL in the SGRQ, the CRQ and the AQ20. Differences between basal and final values in each of the evaluated dimensions were: SGRQ Total =-13,44±9,93, symptoms=-12,25±14,55, activity=- 14,28±12,24, impact=-13,55±13,80; CRQ: dyspnea=1,16±0,75, fatigue=1,04±0,80, emotion=0,83±0,89, mastery=0,95±0,90; AQ20=- 3,16±2,95. A positive response in relation to exercise tolerance and illness prognosis was observed. Following the program patients walked an average of 55,9±39,5 m more (p<.001) and the BODE index was a mean of 1,48±1,20 less regarding the initial value (p<.001). The number of exacerbations showed a reduction of 1,7 by patient in the year post PRP (p=0,000). CONCLUSION: A 7 weeks PRP, emphasizing the muscular training component, achieves immediate benefits over the physical condition and health in COPD patients with exacerbations; and decreases the use of health services by exacerbations.

[gl] Obxectivo: Coñecer a eficacia dun Programa de Rehabilitación Pulmonar (PRP), en pacientes EPOC con exacerbacións, sobre a calidade de vida relacionada coa saúde (CVRS), a tolerancia ao exercicio, o prognóstico da enfermidade e impacto sobre as exacerbacións. Material e método: estudo cuasi-experimental con 31 pacientes EPOC graos III - IV, con 2,4±1,5 exacerbacións por paciente no ano previo. A duración foi de 7 semanas, con entrenamento muscular e educación non formal. Valoráronse o St. George's Respiratory Questionnaire (SGRQ), Chronic Respiratory Questionnaire (CRQ), Airways Questionnaire 20 (AQ20), proba de marcha de seis minutos (PM6M) e índice BODE. As exacerbacións durante o ano seguinte estimáronse con entrevista e revisión da historia clínica. Resultados: Obtívose melloría estatisticamente significativa (p<0,001) e clinicamente relevante nas variables CVRS e tolerancia ao exercicio. Cunha diferencia basal e final no SGRQ: total=-13,44±9,93, síntomas=- 12,25±14,55, actividade=-14,28±12,24, impacto=-13,55±13,80; CRQ: disnea=1,16±0,75, fatiga=1,04±0,80, función emocional=0,83±0,89, control da enfermidade=0,95±0,90; AQ20=-3,16±2,95; e na PM6M=55,9±39,5 m. No índice BODE observouse unha diminución de 1,48±1,20 puntos (p<0,001) e no número de exacerbacións unha redución de 1,7 por paciente durante o ano seguinte (p=0,000). Conclusión: en pacientes EPOC con exacerbacións, un PRP de sete semanas, centrado no entrenamento muscular, acada beneficios inmediatos na condición física e saúde, e diminúe a utilización de servicios sanitarios por agudizacións.