Six-Minute Walking Distance Improvement after Pulmonary Rehabilitation Is Associated with Baseline Lung Function in Complex COPD Patients: A Retrospective Study

Abstract

Introduction. Conflicting results have been so far reported about baseline lung function, as predicting factor of pulmonary rehabilitation (PR) efficacy. Aim. To ascertain whether or not baseline lung function could predict a benefit in terms of a significant change in 6-min walk test (6MWT) after PR. Methods. Seventy-five stable moderate-to-severe COPD inpatients with comorbidities (complex COPD), allocated to a three-week PR program, were retrospectively evaluated. Pulmonary function, 6MWT, dyspnea (BDI/TDI), and quality of life (EQ-VAS) were assessed before and after PR program. The patients were divided into two groups depending on the change in 6MWT (responders > 30 m and nonresponders ≤ 30 m). Logistic regression analysis was used. Results. After PR, 6MWT performance all outcome measures significantly improved (P < 0.01). Compared to nonresponders (N = 38), the responders (N = 37) had lower values in baseline lung function (P < 0.01). Logistic regression analysis showed that FEV1 < 50% pred and TL, CO < 50% pred were independent predictors of PR efficacy. Conclusions. Our study shows that in stable moderate-to-severe complex COPD inpatients, baseline lung function may predict the response to PR in terms of 6MWT. We also found that complex COPD patients with poor lung function get more benefit from PR.

Effects of Pulmonary Rehabilitation in Patients with Non-Cystic Fibrosis Bronchiectasis: A Retrospective Analysis of Clinical and Functional Predictors of Efficacy

“…Similar evidence has been reported in patients with COPD [24,31,32] . As well as for patients with COPD, it is conceivable that even patients with non-CF bronchiectasis and a poor baseline lung function are at risk of entering a downward spiral of dyspnea, sedentariness, demotivation, and, finally, deconditioning [33] .…”

Pulmonary Rehabilitation: A Retrospective Study in Eastern North Carolina

“…Data from other centers showed a mean improvement in 6MWD of 70-190 feet [5,14,16,17]. Mean improvement in 6MWD among patients in our study was greater, at 263.8 feet.…”

Effect of a Three-Week Inpatient Rehabilitation Program on 544 Consecutive Patients with Very Severe COPD: A Retrospective Analysis

“…While some studies showed that baseline characteristics cannot identify pulmonary rehabilitation responders [25], a number of other studies support the hypothesis that poor baseline characteristics tend to result in better improvements: Zanini et al [26] retrospectively conducted a logistic regression analysis to detect predictors of success of a 3-week pulmonary rehabilitation program in 75 COPD patients and found that poor lung function (FEV 1 <50%) was predictive of rehabilitation success in this small group of heterogeneous patients. Furthermore, a lower baseline arterial partial oxygen pressure [27] and poorer health status [28] appear to be predictors of success in pulmonary rehabilitation.…”