Exercise tolerance and symptoms after standard rrehabilitation in emphysema-like COPD patients (original) (raw)

Abstract

In this retrospective analysis on a cohort of 823 COPD patients (age 71±8 yrs, FEV 1 56±18% pr.) admitted in 3 centres, we aimed at describing the effect of standard rehabilitation on exercise tolerance and symptoms in the subgroup of emphysema-like individuals, as defined by lung function parameters. Pre-to-post changes (D) in exercise tolerance (6MWT), Borg dyspnea (D), fatigue (F) and SatO 2 nadir (N) on effort, perceived breathlessness (MRC), and quality-of-life (SGRQ) were reported. Proportion of patients reaching the minimally clinical important difference (MCID) in 6MWT, D, F, MRC and SGRQ were also recorded. Outcomes were then compared between the Emphysema ( E , n=283) and the COPD ( C , n=540) subgroups. Lung functions were different by definition when comparing the two groups, with similar age, body mass, exercise tolerance, and breathlessness at baseline. D-6MWD (+72±47 and +62±42 m, p=0.002), D-D (-2.3±1.7 and -1.9±1.3 point, p=0.002), D-F (-2.2±1.9 and -1.9±1.6 point, p=0.070), and D-N (+1.4±3.0 and +0.5±3.3 point, p=0.002) were higher, whereas a larger proportion of patients improved at the MCID in 6MWT (62% and 54%, p=0.040) in group E when compared with group C. Using a multivariate logistic regression model, we found that higher normalised PaO 2 , and lower 6MWT, and FRC at baseline significantly correlated with D-6MWT within the E group (p This study generates the hypothesis that COPD patients with emphysema phenotype are more likely to gain exercise tolerance and perceived symptoms after standard rehabilitation.

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