COPD patients' ability to follow exercise influences short-term outcomes of rehabilitation
M.A. Puhan 1*,
H.J. Schünemann 2,
G. Buesching 3,
E. vanOort 3,
A. Spaar 1,
M. Frey 3
1 Horten Centre, University of Zurich, Switzerland
2 Clarity Research Group, Dept of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada & Dept. of Medicine, University at Buffalo, NY, USA; and Dept of Epidemiology, Italian National Cancer Institute Regina Elena, Rome, Italy
3 Klinik Barmelweid, Barmelweid, Switzerland
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Abstract |
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COPD patients with limited ability to follow exercise protocols may have smaller benefits from rehabilitation. We assessed the association between the ability to follow exercise protocols and short-term outcomes of rehabilitation in COPD patients.
As measure of the ability to follow exercise protocols, we determined the number of major breaks of
1 minute of 98 COPD patients during supervised exercise sessions. We compared benefits from rehabilitation between patients with, on average, >1 and
1 major breaks per session.
Patients with
1 major break per session showed significantly greater improvements of exercise capacity (between-groups difference of 38 meters [95% CI 8–68] for Six-minute walk distance, 22.1 Watt [5.5–38.7] for short-time maximum exercise capacity [steep ramp test] and 5.5 Watt [0.1–11.1] for maximum exercise capacity). Quality of life also tended to be better in patients with
1 major break per session, but differences were not significant (adjusted between-groups difference of 0.14 [-0.37–0.66]).
Limited ability to follow exercise protocols is associated with smaller benefits from rehabilitation. This finding highlights the importance of choosing tolerable exercise protocols for COPD patients.
Keywords:
COPD, exercise, exercise test, quality of life, respiratory rehabilitation