Efeitos da reabilitação pulmonar comparado ao cuidado clínico usual na percepção de felicidade de indivíduos com DPOC: um ensaio clínico randomizado

Abstract

Introduction: Individuals with Chronic Obstructive Pulmonary Disease (COPD) exhibit emotional alterations, such as low quality of life indicators and a high prevalence of anxiety and depression. It has also been demonstrated that these individuals have a low perception of happiness. Considering that physical exercise increases the perception of happiness in healthy individuals, the hypothesis of this study is that a pulmonary rehabilitation program may lead to an increase in the perception of happiness in individuals with COPD. Objective: To evaluate the effects of pulmonary rehabilitation, compared to usual care, on the perception of happiness in individuals with COPD and to determine which variables are associated with the perception of happiness in this population. Methods: A randomized clinical trial was conducted with individuals of both sexes with COPD. Individuals with other respiratory diseases, unstable cardiovascular diseases, and neurological and/or musculoskeletal disorders were excluded from the study. The experimental group (EG) underwent an 8-week pulmonary rehabilitation program, three times a week, consisting of aerobic exercises (treadmill walking or cycle ergometer for 30 minutes) and resistance exercises for four different muscle groups. The control group received guidance on walking and an educational booklet. Assessments were conducted before and immediately after the rehabilitation program. Primary outcome: Perception of happiness (Subjective Happiness Scale and Cantril Scale). Secondary outcomes: Life satisfaction scale, exercise capacity, peripheral muscle strength, dyspnea, fatigue, quality of life, anxiety, and depression. Data analysis was performed using generalized linear models and linear regression; p < 0.05 was considered significant. Results: Forty-one individuals participated in the study (68 ± 9 years, 59% male, FEV₁: 59 ± 18% predicted), comprising the control group (n = 20) and the rehabilitation group (n = 21). Significant differences between the groups were observed, favoring the rehabilitation group in the Subjective Happiness Scale (0.7 points; 95% CI: 0.4 – 1.1; p < 0.05), the Cantril Scale (2.5 points; 95% CI: 1.7 – 3.4; p < 0.05), and all secondary outcomes. Improvements in the perception of happiness were associated with improvements in CAT, the impact domain of SGRQ, the 6MWT, and handgrip strength. Conclusion: Individuals with COPD who participated in pulmonary rehabilitation showed a significant increase in the perception of happiness compared to those who received only usual care. This improvement is associated with a reduction in disease impact, better quality of life, greater exercise capacity, and increased muscle strength.