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European Journal of Physical and Rehabilitation Medicine 2021 Nov 08

DOI: 10.23736/S1973-9087.21.07059-3

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Predictors of changes in 6-min walking distance following pulmonary rehabilitation in COPD patients: a retrospective cohort analysis

Yara AL CHIKHANIE 1, 2, Sébastien BAILLY 2, Daniel VEALE 1, 2, Frédéric HÉRENGT 1, 2, Samuel VERGES 2

1 Cardiopulmonary rehabilitation center, Dieulefit Santé, Dieulefit, Rhône-Alpes, France; 2 Alps, Inserm U1300, CHU Grenoble Alps, Hp2, University of Grenoble, Grenoble, France


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BACKGROUND: Pulmonary rehabilitation (PR) is fundamental in chronic obstructive pulmonary disease (COPD) management but not all patients may show functional benefits from PR.
AIM: The aim of this study was to identify predictors of non-response in functional capacity to PR.
DESIGN: Observational study.
SETTING: Inpatient pulmonary rehabilitation center.
POPULATION: COPD patients.
METHODS: This single center study is a retrospective analysis of data in COPD patients admitted to a PR center between January 2012 and December 2017. Post-PR change in 6-min walking distance (6MWD) was used to determine the functional response to PR. Patients characteristics and pre-PR 6-min walking test responses were analyzed to determine factors associated with post-PR changes in 6MWD.
RESULTS: Data from 835 patients were analyzed as well as a subgroup of 190 patients with additional variables available. Eighty percent of the patients showed clinically significant 6MWD improvement post-PR. The predictors of 6MWD response to PR were age, pre-PR 6MWD, pre-PR end-of-test dyspnea and long-term oxygen therapy. Older patients, longer pre-PR 6MWD, higher pre-PR end-of-test dyspnea score and the use of oxygen supplementation were associated with lesser post-PR 6MWD improvement.
CONCLUSIONS: This study identified four important clinical variables predicting a lack of 6MWD response to PR. Patients with such clinical characteristics may require specific PR modalities to improve their functional benefit.


KEY WORDS: Chronic obstructive pulmonary disease; Pulmonary rehabilitation; 6-min walking test; Responders and non-responders

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