Pulmonary Rehabilitation in Primary Care: Functional and Emotional Impact in a Patient with COPD: A Case Report

基层医疗中的肺康复:慢性阻塞性肺病患者的功能和情感影响:病例报告

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Abstract

Background and Clinical Significance: Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disorder characterized by airflow limitation and a significant impact on functional capacity, emotional well-being, and quality of life. Pulmonary rehabilitation improves functional capacity and psychosocial outcomes in individuals with COPD, but evidence on its implementation in primary care is limited. This case report describes the functional and emotional outcomes of a structured pulmonary rehabilitation program delivered in a primary care setting for a patient with moderate COPD, indicating potential feasibility and clinical relevance, while recognizing that evidence from a single case cannot be generalized; Case Presentation: A 73-year-old man, an ex-smoker for 10 years, with a history of moderate COPD (GOLD 2/B), controlled hypertension, and recurrent respiratory infections, presented after discontinuation of regular exercise following a previous hospital-based rehabilitation program completed 26 months earlier. The patient reported dyspnea on exertion and functional decline. He completed a 16-week pulmonary rehabilitation program delivered in a primary care setting. The intervention included weekly supervised sessions (breathing exercises, aerobic and resistance training, and education) and twice-weekly home exercises. Outcomes were assessed pre- and post-intervention. Dyspnea improved (mMRC 2 → 1), 6-Minute Walk Test distance increased (303 → 380 m), lower-limb strength improved (10× Sit-to-Stand: 10 → 18 repetitions), perceived exertion decreased (Borg 7 → 4), daily activity limitations were reduced (LCADL 28 → 20), and anxiety decreased (HADS 10 → 6). No adverse events occurred, and adherence was 100%. Conclusions: This single case shows that a structured pulmonary rehabilitation program delivered in primary care was feasible and associated with meaningful improvements in functional performance and emotional well-being in a patient with moderate COPD.

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