scholarly journals The minimal important difference for the endurance shuttle walk test in individuals with chronic obstructive pulmonary disease following a course of pulmonary rehabilitation

2019 ◽  
Vol 16 ◽  
pp. 147997311985382 ◽  
Author(s):  
Jakub Zatloukal ◽  
Sarah Ward ◽  
Linzy Houchen-Wolloff ◽  
Theresa Harvey-Dunstan ◽  
Sally Singh
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Minimal Important Difference ◽  
Chronic Obstructive ◽  
Global Rating ◽  
Walk Test ◽  
Distribution Method ◽  
Obstructive Pulmonary Disease ◽  
A Value

The endurance shuttle walk test (ESWT) is frequently used as an outcome measure for pulmonary rehabilitation (PR). The minimal important difference (MID) for the ESWT after a course of rehabilitation has not been conclusively confirmed in the literature. The aim was to establish the MID for the ESWT following the 6-week PR programme in patients with chronic obstructive pulmonary disease (COPD). Following the completion of the 6-week PR programme, data from 531 participants were included in the analysis to estimate the MID for the ESWT using both anchor-based and distribution-based methods. Mean age (standard deviation (SD)) was 69.4 (9.1) years, 303 male, FEV1/FVC 0.51 (0.16). The baseline incremental shuttle walk test (ISWT) was 217.7 (SD 139.8) metres and ESWT 195.8 (SD 118.8) seconds, which increased to 279.6 (SD 149.5) metres and 537.4 (SD 378.3) seconds, respectively, following PR. The mean change was 61.8 (95% confidence interval (CI) 56.0–67.5) metres for the ISWT and 342.0 (95% CI 312.4–371.6) seconds for the ESWT. The distribution method (0.5 × SD) yielded an MID of 173.7 seconds, the global rating of change scale method yielded a value of 279.2 (95% CI 244.9–313.5) seconds for those rating themselves as ‘slightly improved’ and the ROC method 207 seconds. There was no agreement between the approaches employed. However, we propose that the MID for the ESWT in COPD following a 6-week PR programme is between 174 and 279 seconds.

scholarly journals Success in Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

2010 ◽  
Vol 17 (5) ◽  
pp. 219-223 ◽  
Author(s):  
Adrienne S Scott ◽  
Marcel A Baltzan ◽  
Joel Fox ◽  
Norman Wolkove
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Airflow Obstruction ◽  
Successful Outcome ◽  
Chronic Obstructive ◽  
Walk Test ◽  
Hypoxemic Respiratory Failure ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire

BACKGROUND: Pulmonary rehabilitation (PR) is beneficial for some, but not all, patients with chronic lung disease.OBJECTIVES: To determine the success rate of a comprehensive PR program for patients with chronic obstructive pulmonary disease (COPD) and to characterize the differences between responders and nonresponders.METHODS: A chart review was performed on patients with a clinical diagnosis of COPD who were referred for PR. Success was defined according to clinically important changes in St George’s Respiratory Questionnaire scores and/or 6 min walk test distance.RESULTS: The majority of subjects were men (58%) with a mean (± SD) age of 69±10 years (n=177). Sixty-two per cent of participants had a successful outcome with PR, with proportionally more responders noting subjective improvement than objective improvement on a 6 min walk test (73% versus 51%). Subjects with poor baseline St George’s Respiratory Questionnaire scores tended to improve the most (P=0.011 [ANOVA]). Successful participants had a greater forced expired volume in 1 s (1.1 L versus 0.9 L; P<0.05) and a lower BODE index (body mass index, airflow obstruction, dyspnea, and exercise capacity index) at baseline (9.6 versus 10.3; P<0.05). Success of PR was not correlated with age, sex, chronic hypoxemic respiratory failure or other chronic conditions. Successful participants were more likely to be compliant and to experience fewer adverse events (P≤0.001).CONCLUSIONS: Our study reinforced the belief that the majority of participants with COPD benefit from PR. Few baseline characteristics were predictive of success. Subjectively measured improvement occurred more frequently than objectively measured improvement and was greatest in those with the poorest baseline values.

scholarly journals The responsiveness of the Manchester Chronic Obstructive Pulmonary Disease Fatigue Scale to pulmonary rehabilitation

2019 ◽  
Vol 10 ◽  
pp. 204062231988220 ◽  
Author(s):  
Abebaw Mengistu Yohannes ◽  
Sheila Dryden ◽  
Nicola Alexander Hanania
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Pulmonary Rehabilitation ◽  
Medical Research Council ◽  
Chronic Obstructive ◽  
Walk Test ◽  
Obstructive Pulmonary Disease ◽  
St George's Respiratory Questionnaire ◽  
The Mean

Background: We examined the responsiveness of the Manchester Chronic Obstructive Pulmonary Disease (COPD) Fatigue Scale (MCFS) in patients with COPD following 8 weeks of pulmonary rehabilitation (PR). Methods: Patients ( n = 273) with clinically stable COPD completed 8 weeks of outpatient multidisciplinary PR, comprising 2 h (1 h exercise and 1 h education) weekly. Anxiety, exercise capacity, quality of life, dyspnea, fatigue were measured pre- and post-PR, utilizing the Anxiety Inventory for Respiratory Disease (AIR), Incremental Shuttle Walk Test (ISWT), St. George’s Respiratory Questionnaire (SGRQ), and modified Medical Research Council (mMRC) scale and MCFS, respectively. Results: The mean (SD) age of participants was 72 (8) years, and 50% were women. Total MCFS score fell after PR mean (95% confidence interval) −4.89 (–7.90 to −3.79) as did domain scores: physical −1.89 (–2.33 to −1.46), cognition −1.37 (–1.65 to −1.09), and psychosocial −1.62 (–2.00 to −1.62). Total MCFS effect size (ES) was 0.55; and for domains, physical was 0.52, cognition was 0.59, and psychosocial was 0.51. The ES for AIR was 0.30, mMRC was 0.38, SGRQ was 0.66, and ISWT was 1.19. MCFS changes correlated with changes in both SGRQ ( p < 0.002) and AIR ( p < 0.004), but not ISWT ( p = 0.30) or mMRC ( p = 0.18). The AIR, SGRQ, mMRC, and ISWT all improved after PR (all, p < 0.001). Conclusion: The MCFS scale is a valid and responsive scale to measure fatigue in patients with COPD after pulmonary rehabilitation.

scholarly journals Safety and efficacy of inpatient pulmonary rehabilitation for patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e043377
Author(s):  
Kai Zhu ◽  
Jagdeep Gill ◽  
Ashley Kirkham ◽  
Joel Chen ◽  
Amy Ellis ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Pulmonary Rehabilitation ◽  
Meta Analysis ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Safety And Efficacy

IntroductionPulmonary rehabilitation (PR) following an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) reduces the risk of hospital admissions, and improves physical function and health-related quality of life. However, the safety and efficacy of in-hospital PR during the most acute phase of an AECOPD is not well established. This paper describes the protocol for a systematic review with meta-analysis to determine the safety and efficacy of inpatient acute care PR during the hospitalisation phase.Methods and analysisMedical literature databases and registries MEDLINE, EMBASE, Physiotherapy Evidence Database, Cumulative Index to Nursing and Allied Health Literature, Canadian Agency for Drugs and Technologies in Health, CENTRAL, Allied and Complementary Medicine Database, WHO trials portal and ClinicalTrials.gov will be searched for articles from inception to June 2021 using a prespecified search strategy. We will identify randomised controlled trials that have a comparison of in-hospital PR with usual care. PR programmes had to commence during the hospitalisation and include a minimum of two sessions. Title and abstract followed by full-text screening will be conducted independently by two reviewers. A meta-analysis will be performed if there is sufficient homogeneity across selected studies or groups of studies. The Population, Intervention, Comparator, Outcomes and Study characteristics framework will be used to standardise the data collection process. The quality of the cumulative evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations framework.Ethics and disseminationAECOPD results in physical limitations which are amenable to PR. This review will assess the safety and efficacy of in-hospital PR for AECOPD. The results will be presented in a peer-reviewed publication and at research conferences. Ethical review is not required for this study.

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