Impact Of Pulmonary Rehabilitation and Smoking Cessation on Clinical and Spirometric Outcomes in Smokers with Preserved Ratio Impaired Spirometry: A 12-Month Prospective Follow-Up Study
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Abstract
Background
Preserved ratio impaired spirometry (PRISm) represents a distinct spirometric phenotype characterised by reduced forced expiratory volume in one second (FEV₁ <80% predicted) with a preserved FEV₁/FVC ratio (≥0.70). Individuals with PRISm frequently demonstrate respiratory symptoms, impaired quality of life, and increased risk of progression to chronic obstructive pulmonary disease (COPD). Evidence regarding early intervention strategies in this population remains limited.
Objective
To evaluate the impact of pulmonary rehabilitation in addition to smoking cessation on symptom burden and spirometric outcomes among smokers with PRISm over a twelve-month follow-up period.
Materials and Methods
A prospective follow up study was conducted in a tertiary care centre. Smokers aged 25–55 years diagnosed with PRISm were enrolled and received structured pulmonary rehabilitation along with intensive smoking cessation. Participants underwent clinical assessment and spirometry at baseline and every two months for twelve months. Symptom burden was assessed using the COPD Assessment Test (CAT), modified Medical Research Council (mMRC) dyspnoea scale, and St George’s Respiratory Questionnaire (SGRQ). Spirometric outcomes included post-bronchodilator FEV₁% predicted, FVC% predicted, and FEV₁/FVC ratio.