title: Metabolic disease and participant age are independent predictors of response to pulmonary rehabilitation.
abstract: OBJECTIVE
  The study aims were (1) to determine whether baseline measures-including the Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) index; Age, Dyspnea, and Airflow Obstruction (ADO) index; physical activity; comorbidities (cardiac, metabolic, or musculoskeletal disease); and the number of hospitalizations over the previous 12 months-can predict responders in 6-minute walk distance (6MWD) following pulmonary rehabilitation (PR) and (2) to determine whether different methods in defining improvement in 6MWD affected identifying responders to PR.
  
  
  METHODS
  All participants with chronic obstructive pulmonary disease who attended PR at our institution between 2004 and 2009 were evaluated. A participant was classified as a responder with improvement in 6MWD (≥25 m or ≥2 SD of this dataset coefficient of repeatability).
  
  
  RESULTS
  A total of 203 participants (mean age, 68.2 ± 8.7 years; mean predicted forced expiratory volume in 1 second, 52.5 ± 22.4%) were analyzed. One hundred twenty participants (59.1%) had a comorbidity categorized as cardiac, metabolic, or musculoskeletal disease. The binary logistic regression models showed that younger participants (P ≤ .015) and, when using the coefficient of repeatability method (≥60.9 m), participants with metabolic disease (P = .040) were the only independent predictors of response. No other measure, including participant BODE or ADO index scores, contributed to either model.
  
  
  CONCLUSIONS
  Identifying responders in exercise capacity following PR remains difficult, with only age and participants with metabolic disease identified as independent predictors.
authors.affiliation: Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, QLD 4032, Australia. james_walsh@health.qld.gov.au
authors.forename: James R
authors.initials: JR
authors.lastname: Walsh
authors.forename: Zoe J
authors.initials: ZJ
authors.lastname: McKeough
authors.forename: Norman R
authors.initials: NR
authors.lastname: Morris
authors.forename: Angela T
authors.initials: AT
authors.lastname: Chang
authors.forename: Stephanie T
authors.initials: ST
authors.lastname: Yerkovich
authors.forename: Helen E
authors.initials: HE
authors.lastname: Seale
authors.forename: Jenny D
authors.initials: JD
authors.lastname: Paratz
mesh_terms: D000367:Age Factors; D000368:Aged; D015992:Body Mass Index; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology*; D009043:Motor Activity / Q000502:physiology*; D015995:Prevalence; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000534:rehabilitation*; D011793:Queensland / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors