Abstract
Objective
To evaluate the effect of pulmonary rehabilitation (PR) on exercise performance and
quality of life in patients with chronic obstructive pulmonary disease (COPD) with
different degrees of static lung hyperinflation (LH).
Design
Retrospective cohort study.
Setting
PR network.
Participants
A cohort of 1981 patients with COPD (55% men; age: 66.8±9.3y; forced expiratory volume
in the first second%: 50.7±19.5; residual volume [RV]%: 163.0±49.7).
Intervention
An interdisciplinary PR program for patients with COPD consisting of 40 sessions.
Main Outcome Measures
Participants were stratified into 5 quintiles according to baseline RV and were evaluated
on the basis of pre- and post-PR 6-minute walk distance (6MWD), constant work rate
test (CWRT), and Saint George’s Respiratory Questionnaire (SGRQ), among other clinical
parameters.
Results
With increasing RV quintile, patients were younger, more frequently women, had lower
forced expiratory volume in the first second%, lower body mass index and fat-free
mass index, shorter 6MWD, shorter CWRT, and worse SGRQ scores (P<.01). All RV strata improved after PR in all 3 outcomes (P<.001). Nevertheless, higher, compared to lower RV categories, had lower ΔCWRT (P<.01) but similar Δ6MWD (P=.948) and ΔSGRQ (P=.086) after PR.
Conclusions
LH in COPD is related to younger age, female sex, lower body weight, worse exercise
capacity and health status, but did not prevent patients from benefitting from PR.
LH, however, influences walking and cycling response after PR differently.
Keywords
List of abbreviations:
BMI (body mass index), COPD (chronic obstructive pulmonary disease), CIRO (Center of Expertise for Chronic Organ Failure), CWRT (constant work rate test), FFMI (fat-free mass index), LH (lung hyperinflation), MCID (minimal clinically important difference), PR (pulmonary rehabilitation), 6MWD (6-minute walk distance), SGRQ (Saint George’s Respiratory Questionnaire), RV (residual volume)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 12, 2018
Footnotes
Disclosures: none.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
