Adventitious respiratory sounds (ARS) provide valuable information on the respiratory system and may contribute for diagnosing acute exacerbations in Chronic Obstructive Pulmonary Disease (AECOPD). However, it is unknown how ARS behave during stable and exacerbation periods of the disease. Thus, this study compared ARS between patients with stable and exacerbated COPD.

FEV1, despite being the global outcome for chronic obstructive pulmonary disease (COPD), is poorly responsive to pulmonary rehabilitation (PR). Adventitious respiratory sounds, namely crackles, are a promising measure to assess the effectiveness of respiratory interventions on lung function. However, crackles' sensitivity to PR has never been explored. Thus, this study explored the sensitivity of crackles' characteristics to PR.

Pulmonary Rehabilitation (PR) is a core component of the management of patients with moderate-to-very-severe chronic obstructive pulmonary disease (COPD). However, impairments in quadriceps muscle strength and health-related quality of life (HRQL) are already present in patients with mild COPD. Thus, there is a need to investigate if PR could also be beneficial to these patients. This study assessed the impact of PR on different health domains in patients with mild COPD. Twenty participants (66.1±10.8yrs; forced expiratory volume in one second 88.9±11.3% predicted) enrolled in a primary care PR program, with exercise training and psychoeducation (12 weeks). Dyspnea was assessed with the Modified British Medical Research Council questionnaire; functional balance with the Timed Up and Go test; muscle strength with the 10 repetition maximum testing; exercise tolerance with the 6-minute walking test and HRQL with the St. George's Respiratory Questionnaire (SGRQ). Significant effects were observed on participants' dyspnea (median 1 vs. 0.5; p=0.003), functional balance (7.7±1.4s vs. 6.6±1.1s; p=0.001), knee extensors strength (4.3±2.1kg vs. 6.7±1.7kg; p<0.001) and exercise tolerance (439±80.9m vs. 470.8±79.6m; p=0.001). With the exception of the SGRQ impact score (19.7±17.9 vs. 15.5±15.9; p=0.057), the symptoms (48.5±20.9 vs. 34.8±23.5), activities (48±23.6 vs. 33.3±26.4) and total (33.1±18.3 vs. 24.2±19.4) scores improved significantly with PR (p<0.001). Patients with mild COPD benefit from PR and may gain from being routinely included in these programs. Studies with more robust designs and with long-term follow-ups are needed to inform guidelines for PR in mild COPD.

Pulmonary rehabilitation is a core component of the management of patients with chronic obstructive pulmonary disease (COPD), however, patients are not referred until they have advanced COPD. Nevertheless, it is unknown if patients with mild COPD are also symptomatic and experience restrictions in their daily life.

Background: The World Health Organization has emphasised the need for a patient-centred health care for the management of chronic conditions. COPD is a highly incapacitating chronic disease and its non-pharmacological management has been based on pulmonary rehabilitation programs. However, patients' perspectives regarding their own concerns have received little attention from these programs, which is crucial to design adequate patient-centred interventions. Aims and objectives: This study aimed to identify the concerns and fears of patients with moderate-to-very severe COPD, regarding their actual and future condition. Methods: A qualitative, cross-sectional study was carried out with 18 COPD outpatients. Data were collected using audiotaped semi-structured interviews to capture patients' detailed perceptions. A thematic analysis was performed by 2 independent judges. Results: Participants were mostly male (n=11; 61.1%), with a mean age of 58.4 (SD=8.3) years old and a mean FEV1 percentage predicted of 43.1 (SD=17.7)%. Patients were mainly concerned about the progression of their condition (n=10; 55.5%) associated with the deterioration of their physical capacities (n=5; 27.8%) and becoming older (n=3; 16.7%). Fears about being on their own (n=3; 16.7%) and dying due to their respiratory disease (n=9; 50%), particularly dying of asphyxiation (n= 6; 33.3%), were also reported by patients. Conclusions: The findings suggest that patients with COPD have significant concerns and fears about the irreversible process of their disease. Adequate knowledge about these aspects will allow health professionals to adjust pulmonary rehabilitation programs considering the patients' emotional needs.