Assessing the Impact of Pulmonary Rehabilitation on Functional Status in Chronic Obstructive Pulmonary Disease

Abstract

Background: The optimal way of assessing the impact of pulmonary rehabilitation on functional status in chronic obstructive pulmonary disease (COPD) is currently unknown. The minimal clinically important difference for the constant work rate cycling exercise test also needs to be investigated to facilitate its interpretation. A study was undertaken to evaluate the changes in the 6-min walking test and in the constant work rate cycle endurance test immediately following and 1 year after pulmonary rehabilitation, together with the importance of these changes in terms of health status in patients with COPD. Methods: Patients with COPD of mean (SD) age 65 (8) years and mean (SD) forced expiratory volume in 1 s (FEV 1 ) 45 (15)% predicted were recruited from a multicentre prospective cohort study and evaluated at baseline, immediately after a pulmonary rehabilitation programme (n = 157) and at 1 year (n = 106). The 6-min walking test and the cycle endurance test were performed at each evaluation. Health status was evaluated with the St George Respiratory Questionnaire. Results: Following pulmonary rehabilitation, cycle endurance time increased (198 (352) s, p,0.001) and stayed over baseline values at 1 year (p,0.001). The 6-min walking distance also showed improvements following rehabilitation (25 (52) m, p,0.001) but returned to baseline values at the 1-year follow-up. Changes in cycle endurance time were more closely associated with changes in health status than with the 6-min walking test.

Fatores associados à diferença clinicamente significativa da qualidade de vida relacionada à saúde após condicionamento físico em pacientes com DPOC

“…In accordance with the findings of the present study, one group of authors (26) observed no correlation between improved quality of life and improved 6MWT results. In that study, (26) COPD patients were submitted to a pulmonary rehabilitation program and were monitored for one year after the completion of the program.…”

“…In that study, (26) COPD patients were submitted to a pulmonary rehabilitation program and were monitored for one year after the completion of the program. The authors noted that, unlike improved 6MWT results, improved endurance cycle ergometer test results correlated with improvement in the SGRQ activity domain score, impact domain score and total score after follow-up.…”

Effects of inpatient pulmonary rehabilitation in patients with interstitial lung disease

“…The benefits of PR have been extensively reported in patients with chronic obstructive pulmonary disease (COPD), with the assumption that the recommendations are applicable to subjects with other lung diseases [4,5]. Benefits of PR in COPD patients are reported in view of decreased dyspnoea, increased exercise endurance, improved HRQL and reduced healthcare costs [5][6][7][8][9]. However, data supporting PR in patients with ILD are scarce and the effects of PR in patients with ILD are largely unknown.…”

Prospective validation of the endurance shuttle walking test in the context of bronchodilation in COPD

“…As such, measuring the endurance to constant load exercise has been an important objective of several clinical trials evaluating the impact of pharmacological or rehabilitative interventions in COPD [3][4][5]. In this context, the endurance shuttle walking test (ESWT) is gaining acceptance due to its minimal requirement for equipment, low cost and ease of administration [6], and to its responsiveness and sensitivity to interventions, at least in single centre studies [7][8][9][10][11][12].…”