Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial

Journal article


Luk, Edwin K., Gorelik, Alex, Irving, Louis and Khan, Fary. (2017). Effectiveness of cognitive behavioural therapy in a community-based pulmonary rehabilitation programme: A controlled clinical trial. Journal of Rehabilitation Medicine. 49(3), pp. 264 - 269. https://doi.org/10.2340/16501977-2189
AuthorsLuk, Edwin K., Gorelik, Alex, Irving, Louis and Khan, Fary
Abstract

Objective: To investigate whether the use of cognitive behavioural therapy in pulmonary rehabilitation addresses the depression and anxiety burden and thereby improves rehabilitation outcomes. Design: Prospective controlled clinical trial. Patients: A total of 70 patients with chronic obstructive pulmonary disease who were referred to a community centre for pulmonary rehabilitation. Methods: Patients were allocated to either the control group, consisting of pulmonary rehabilitation alone, or to the treatment group, receiving pulmonary rehabilitation and an additional 6 sessions of group-based cognitive behavioural therapy. Assessments consisting of questionnaires and walk tests were conducted pre- and post-pulmonary rehabilitation. Results: A total of 28 patients were enrolled. The cognitive behavioural therapy group had significant improvements in exercise capacity following pulmonary rehabilitation (mean change 32.9 m, p = 0.043), which was maintained at 3 months post-pulmonary rehabilitation (mean change 23.4 m, p = 0.045). Patients in the cognitive behavioural therapy group showed significant short-term improvements in fatigue, stress and depression (mean change 2.4, p = 0.016, 3.9, p = 0.024 and 4.3, p = 0.047, respectively) and a 3-month post-pulmonary rehabilitation improvement in anxiety score (mean change 3.1, p = 0.01). No significant changes were seen in the control group. Conclusion: The addition of cognitive behavioural therapy improved patients’ physical, psychological and quality of life results. Cognitive behavioural therapy should be considered for inclusion in a pulmonary rehabilitation programme to enhance outcomes.

Keywordspulmonary disease; chronic obstructive; pulmonary rehabilitation; cognitive therapy; psychotherapy
Year2017
JournalJournal of Rehabilitation Medicine
Journal citation49 (3), pp. 264 - 269
PublisherFoundation for Rehabilitation Information
ISSN1650-1977
Digital Object Identifier (DOI)https://doi.org/10.2340/16501977-2189
Scopus EID2-s2.0-85015236328
Page range264 - 269
Publisher's version
File Access Level
Controlled
Place of publicationSweden
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Physical therapists as primary practitioners in the emergency department: Six-month prospective practice analysis
de Gruchy, Adam, Granger, Catherine L. and Gorelik, Alexandra. (2015). Physical therapists as primary practitioners in the emergency department: Six-month prospective practice analysis. Physical Therapy. 95(9), pp. 1207 - 1216. https://doi.org/10.2522/ptj.20130552
Obesity is associated with retinopathy and macrovascular disease in type 1 diabetes
Price, Sarah A., Gorelik, Alexandra, Fourlanos, Spiros, Colman, Peter G. and Wentworth, John M.. (2014). Obesity is associated with retinopathy and macrovascular disease in type 1 diabetes. Obesity Research and Clinical Practice. 8(2), pp. e178 - e182. https://doi.org/10.1016/j.orcp.2013.03.007
IDH1 mutation is associated with seizures and protoplasmic subtype in patients with low-grade gliomas
Liubinas, Simon V., D'Abaco, Giovanna M., Moffat, Bradford M., Gonzales, Michael, Feleppa, Frank, Nowell, Cameron J., Gorelik, Alexandra, Drummond, Katharine J., O'Brien, Terence J., Kaye, Andrew H. and Morokoff, Andrew P.. (2014). IDH1 mutation is associated with seizures and protoplasmic subtype in patients with low-grade gliomas. Epilepsia. 55(9), pp. 1438 - 1443. https://doi.org/10.1111/epi.12662
Lifetime risk of total knee replacement and temporal trends in incidence by health care setting, socioeconomic status, and geographic location
Bohensky, Megan A., Ackerman, Ilana, Desteiger, Richard, Gorelik, Alexandra and Brand, Caroline A.. (2014). Lifetime risk of total knee replacement and temporal trends in incidence by health care setting, socioeconomic status, and geographic location. Arthritis Care and Research. 66(3), pp. 424 - 431. https://doi.org/10.1002/acr.22122
Lifetime risk of total hip replacement surgery and temporal trends in utilization: A population-based analysis
Bohensky, Megan A., Ackerman, Ilana, De Steiger, Richard, Gorelik, Alexandra and Brand, Caroline A.. (2014). Lifetime risk of total hip replacement surgery and temporal trends in utilization: A population-based analysis. Arthritis Care and Research. 66(8), pp. 1213 - 1219. https://doi.org/10.1002/acr.22279
Outcomes of ambulatory rehabilitation programmes following botulinum toxin for spas ticity in adults with stroke
Demetrios, Marina, Gorelik, Alexandra, Louie, Julie, Brand, Caroline A., Baguley, Ian J. and Khan, Fary. (2014). Outcomes of ambulatory rehabilitation programmes following botulinum toxin for spas ticity in adults with stroke. Journal of Rehabilitation Medicine. 46(8), pp. 730 - 737. https://doi.org/10.2340/16501977-1842
Drug-induced hepatotoxicity: Incidence of abnormal liver function tests consistent with volatile anaesthetic hepatitis in trauma patients
Lin, Jonathan, Moore, David, Hockey, Brad, Di Lernia, Rachel, Gorelik, Alexandra, Liew, Danny and Nicoll, Amanda J.. (2014). Drug-induced hepatotoxicity: Incidence of abnormal liver function tests consistent with volatile anaesthetic hepatitis in trauma patients. Liver International. 34(4), pp. 576 - 582. https://doi.org/10.1111/liv.12278
Predictors of health care use among patients with or at high risk of atherothrombotic disease: Two-year follow-up data
Ademi, Zanfina, Liew, Danny, Gorelik, Alexandra, Bohensky, Megan A., Zomer, Ella, Hollingsworth, Bruce, Steg, Gabriel, Bhatt, Deepak L. and Reid, Christopher M.. (2014). Predictors of health care use among patients with or at high risk of atherothrombotic disease: Two-year follow-up data. International Journal of Cardiology. 175(1), pp. 72 - 77. https://doi.org/10.1016/j.ijcard.2014.04.230
Long term follow-up after aortic valve replacement (Ross Procedure): Echocardiographic determinants of ventricular recovery
Wilson, William M., Grigg, Leeanne E., Gorelik, Alexandra and Skillington, Peter. (2014). Long term follow-up after aortic valve replacement (Ross Procedure): Echocardiographic determinants of ventricular recovery. Heart, Lung and Circulation. 23(2), pp. 132 - 143. https://doi.org/10.1016/j.hlc.2013.07.008
Geographical variation in incidence of knee arthroscopy for patients with osteoarthritis: A population-based analysis of Victorian hospital separations data
Bohensky, Megan A., Barker, Anna, Morello, Renata Teresa, De Steiger, Richard N., Gorelik, Alexandra and Brand, Caroline A.. (2014). Geographical variation in incidence of knee arthroscopy for patients with osteoarthritis: A population-based analysis of Victorian hospital separations data. Internal Medicine Journal. 44(6), pp. 537 - 545. https://doi.org/10.1111/imj.12438
Thyroid surgery and anticoagulation: Survey of practice of endocrine surgeons in Australia
Verma, Kunal Pradip, Gorelik, Alexandra and Miller, Julie A.. (2013). Thyroid surgery and anticoagulation: Survey of practice of endocrine surgeons in Australia. World Journal of Endocrine Surgery. 5(1), pp. 6 - 11. https://doi.org/10.5005/jp-journals-10002-1115
Primary angiitis of the central nervous system: Experience of a Victorian tertiary-referral hospital
Oon, S., Roberts, Carol, Gorelik, Alexandra, Wicks, I. and Brand, Caroline A.. (2013). Primary angiitis of the central nervous system: Experience of a Victorian tertiary-referral hospital. Internal Medicine Journal. 43(6), pp. 685 - 692. https://doi.org/10.1111/imj.12038
Outcomes and excess costs among patients with cardiovascular disease
Ademi, Zanfina, Liew, Danny, Zomer, Ella, Gorelik, Alexandra, Hollingsworth, Bruce, Steg, Philippe Gabriel, Bhatt, Deepak L. and Reid, Christopher M.. (2013). Outcomes and excess costs among patients with cardiovascular disease. Heart, Lung and Circulation. 22(9), pp. 724 - 730. https://doi.org/10.1016/j.hlc.2013.02.002
Epidemiology of hepatitis B-associated hepatocellular carcinoma in Victoria
Sinclair, M., Roberts, S., Kemp, W., Knight, V., Dev, A., Gow, P., Philpott, H., Kronborg, Ian, Arachchi, Niranjan J., Bell, Sally J., Lim, Lucy, Gorelik, Alexandra and Nicoll, Amanda J.. (2013). Epidemiology of hepatitis B-associated hepatocellular carcinoma in Victoria. Internal Medicine Journal. 43(5), pp. 501 - 506. https://doi.org/10.1111/imj.12068
Who, why and when: Stroke care unit patients seen by a palliative care service within a large metropolitan teaching hospital
Eastman, Peter, McCarthy, Gillian, Brand, Caroline A., Weir, Louise, Gorelik, Alexandra and Le, Brian. (2013). Who, why and when: Stroke care unit patients seen by a palliative care service within a large metropolitan teaching hospital. BMJ Supportive and Palliative Care. 3(1), pp. 77 - 83. https://doi.org/10.1136/bmjspcare-2012-000331