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A better response in exercise capacity after pulmonary rehabilitation in more severe COPD patients.
MedLine Citation:
PMID:  22154126     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: Pulmonary rehabilitation (PR) has positive effects on exercise capacity in Chronic Obstructive Pulmonary Disease (COPD). However, not all COPD patients benefit from PR to the same extent. We investigated whether there is a patient profile, which is associated with the improvement in endurance exercise capacity. METHODS: In this observational study, we included 102 COPD patients who followed PR (age 60 ± 10 (mean ± SD) years, FEV(1)%predicted 44 ± 16%, 54 men). Lung function, maximal incremental cycle testing (Wpeak, VO(2)peak, Δlactate), quadriceps force and incremental and endurance shuttle walk test (ISWT/ESWT) were performed at the start of PR. The ESWT was repeated after 7 weeks of PR. RESULTS: Mean change in ESWT (ΔESWT) was 100 ± 154%. Four variables showed a statistically significant negative correlation with ΔESWT: FEV(1)%pred. (ρ = -0.20), Wpeak (ρ = -0.24), Δlactate (ρ = -0.33) and incremental shuttle walk test (ISWT) (ρ = -0.31). A cluster analysis identified two patient profiles: A profile with high ΔESWT, TLC and RV and low FEV(1), VO(2)peak, quadriceps force, Δlactate, HR(peak)%pred. and ISWT distance and a profile with low ΔESWT, TLC and RV and high FEV(1), VO(2)peak, quadriceps force, Δlactate, HR(peak)%pred. and ISWT distance. CONCLUSIONS: Single variables from lung function or exercise testing at baseline have limited predictive value for response to exercise training. However, patients with worse disease status (i.e. a combination of lower FEV(1), more hyperinflation, lower exercise capacity and worse quadriceps force) improve more in endurance exercise capacity.
Authors:
Wytske A Altenburg; Mathieu H G de Greef; Nick H T Ten Hacken; Johan B Wempe
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-12-6
Journal Detail:
Title:  Respiratory medicine     Volume:  -     ISSN:  1532-3064     ISO Abbreviation:  -     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Pulmonary Diseases, University Medical Centre Groningen, University of Groningen, P.O. Box 30001, Internal Mail Address AA11, 9700 RB Groningen, The Netherlands.
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