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The likelihood of improving physical activity after pulmonary rehabilitation is increased in patients with COPD who have better exercise tolerance

 

Authors Osadnik CR, Loeckx M, Louvaris Z, Demeyer H, Langer D, Rodrigues FM, Janssens W, Vogiatzis I, Troosters T

Received 25 May 2018

Accepted for publication 22 August 2018

Published 24 October 2018 Volume 2018:13 Pages 3515—3527

DOI https://doi.org/10.2147/COPD.S174827

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Richard Russell

Purpose: Pulmonary rehabilitation (PR) enhances exercise tolerance in patients with COPD; however, improvements in physical activity (PA) are not guaranteed. This study explored the relationship between baseline exercise tolerance and changes in PA after PR.
Materials and methods: Patient data from prospective clinical trials in the PR settings of Athens and Leuven (2008–2016) were analyzed. Validated PA monitors were worn for 1 week before and after a 12-week program. The proportion of patients who improved PA levels ≥1,000 steps/day (“PA responders”) after PR was compared between those with initial 6-minute walk distance [6MWDi] <350 m and ≥350 m. Baseline predictors of PA change were evaluated via univariate and multivariate logistic regression analyses.
Results: Two hundred thirty-six patients with COPD (median [IQR] FEV1 44 [33–59] % predicted, age 65±8 years, 6MWDi 416 [332–486] m) were included. The proportion of “PA responders” after PR was significantly greater in those with higher vs lower 6MWDi (37.9% vs 16.4%, respectively; <0.001). 6MWDi group classification was the strongest baseline independent predictor of PA improvement (univariate OR 3.10, 95% CI 1.51–6.36).
Conclusion: The likelihood of improving PA after PR is increased with greater 6MWDi. Baseline exercise tolerance appears as an important stratification metric for future research in this field.
Keywords: exercise and pulmonary rehabilitation, COPD, physical activity, clinical respiratory medicine, responder analysis



摘要视频链接:Physical activity changes after PR in patients with COPD