title: Effectiveness of pulmonary rehabilitation in exercise capacity and quality of life in chronic obstructive pulmonary disease patients with and without global fat-free mass depletion.
abstract: OBJECTIVE
  To investigate the effectiveness of pulmonary rehabilitation (PR) in exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD) with and without global fat-free mass (FFM) depletion.
  
  
  METHODS
  Retrospective case-control.
  
  
  METHODS
  Outpatient clinic, university center.
  
  
  METHODS
  COPD patients (N=102) that completed PR were initially evaluated.
  
  
  METHODS
  PR including whole-body and weight training for 12 weeks, 3 times per week.
  
  
  METHODS
  St. George Respiratory Questionnaire (SGRQ), 6-minute walk distance (6MWD), and FFM evaluation applied before and after PR.
  
  
  RESULTS
  Patients were stratified according to their FFM status measured by bioelectric impedance. They were considered depleted if the FFM index was ≤ 15 kg/m(2) in women and ≤ 16 kg/m(2) in men. From the initial sample, all depleted patients (n=31) composed the FFM depleted group. It was composed predominantly by women (68%) with a mean age ± SD of 64.4 ± 7.3 years and a forced expiratory volume in 1 second of 33.6%=-13.2% predicted. Paired for sex and age, 31 nondepleted patients were selected from the initial sample to compose the nondepleted group. Improvement in the 6MWD was similar in these 2 groups after PR. Both groups improved SGRQ scores, although the observed power was small and did not allow adequate comparison between depleted and nondepleted patients. There was no difference between groups in weight change, whereas FFM tended to be greater in depleted patients. This increase had no correlation with the 6MWD or the SGRQ.
  
  
  CONCLUSIONS
  Benefits of PR to exercise capacity were similar comparing FFM depleted and nondepleted COPD patients. Although FFM change tended to be greater in depleted patients, this increase had no definite relation with clinical outcomes.
authors: Post-Graduate Program in Sciences (Pulmonology), Federal University of Rio Grande do Sul, Porto Alegre, Brazil. dcberton@gmail.com
authors: Danilo C
authors: DC
authors: Berton
authors: Leonardo
authors: L
authors: Silveira
authors: Cassia C
authors: CC
authors: Da Costa
authors: Rafael Machado
authors: RM
authors: De Souza
authors: Claudia D
authors: CD
authors: Winter
authors: Paulo José
authors: PJ
authors: Zimermann Teixeira
mesh_terms: D015992:Body Mass Index; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D009133:Muscular Atrophy / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014797:Vital Capacity
keywords: 6-minute walk distance; 6MWD; BMI; COPD; Exercise; FEV(1); FFM; FVC; HRQOL; MANOVA; MRC; Medical Research Council; Muscles; PR; Pulmonary disease; RM; Rehabilitation; SGRQ; St. George Respiratory Questionnaire; body mass index; chronic obstructive; chronic obstructive pulmonary disease; fat-free mass; forced expiratory volume in 1 second; forced vital capacity; health-related quality of life; multiple analysis of variance; pulmonary rehabilitation; repetition maximum