TY - JOUR
T1 - The likelihood of improving physical activity after pulmonary rehabilitation is increased in patients with COPD who have better exercise tolerance
AU - Osadnik, Christian R.
AU - Loeckx, Matthias
AU - Louvaris, Zafeiris
AU - Demeyer, Heleen
AU - Langer, Daniel
AU - Rodrigues, Fernanda M.
AU - Janssens, Wim
AU - Vogiatzis, Ioannis
AU - Troosters, Thierry
PY - 2018/10/24
Y1 - 2018/10/24
N2 - 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; P<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.
AB - 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; P<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.
KW - clinical respiratory medicine
KW - COPD
KW - exercise and pulmonary rehabilitation
KW - physical activity
KW - responder analysis
UR - http://www.scopus.com/inward/record.url?scp=85057562507&partnerID=8YFLogxK
U2 - 10.2147/COPD.S174827
DO - 10.2147/COPD.S174827
M3 - Article
C2 - 30498342
AN - SCOPUS:85057562507
VL - 13
SP - 3515
EP - 3523
JO - International Journal of Chronic Obstructive Pulmonary Disease
JF - International Journal of Chronic Obstructive Pulmonary Disease
SN - 1178-2005
ER -
