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A Journal on Diseases of the Respiratory System
Official Journal of the Italian Society of Thoracic Endoscopy
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Minerva Pneumologica 2004 June;43(2):57-62
Assessment of parameters predicting improvement of FEV1 in patients with COPD undergoing pulmonary rehabilitation
Riario-Sforza G. G., Incorvaia C., Paterniti F., Dugnani N., Fumagalli M.
Aim. Pulmonary rehabilitation (PR) is an accepted treatment for patients with chronic obstructive pulmonary disease (COPD), aimed at reducing disability and improving quality of life, but it is considered unable to improve lung function. A group of patients demonstrating an improvement of FEV1 during PR has been studied to investigate the parameters possibly involved in such event.
Methods. A group of 39 subjects with FEV1 improvement and an equal number of subjects with no change of FEV1 during PR were included in the study. The assessed parameters were: COPD duration, smoking, concomitant cardiopathy, occurrence of exacerbations, use of inhaled ß2-agonists and corticosteroids, desaturation of oxyhemoglobin during walking test, and values of maximum inspiratory mouth pressure (MIP)/maximum expiratory mouth pressure (MEP), forced vital capacity (FVC), and residual volume (RV). PR was performed by a schedule in 8 visits in 4 weeks, with exercise and respiratory muscle training. The FEV1 values in the 2 groups were analyzed by receiver operating characteristic (ROC) curves, and the assessed parameters were compared by the x2 test.
Results. The ROC curve showed a cutoff with poor sensitivity and specificity (59% and 38%), indicating that the basal value of FEV1 was of little importance. Among the parameters examined, only the occurrence of exacerbations, concerning 12 of 39 subjects with improvement of FEV1 and 29 of 39 subjects without improvement of FEV1, achieved statistical significance, with a p=0.048.
Conclusion. In patients with COPD showing a FEV1 improvement during PR the absence of exacerbations seems related to this positive clinical response. An adequate follow-up should investigate whether the improvement of lung function is maintained over time.