Six-minute walking distance improvement after pulmonary rehabilitation is associated with baseline lung function in complex COPD patients: a retrospective study.
BACKGROUND
Conflicting results have been so far reported about baseline lung function, as predicting factor of pulmonary rehabilitation (PR) efficacy.


OBJECTIVE
To ascertain whether or not baseline lung function could predict a benefit in terms of a significant change in 6-min walk test (6 MWT) after PR.


METHODS
Seventy-five stable moderate-to-severe COPD inpatients with comorbidities (complex COPD), allocated to a three-week PR program, were retrospectively evaluated. Pulmonary function, 6 MWT, dyspnea (BDI/TDI), and quality of life (EQ-VAS) were assessed before and after PR program. The patients were divided into two groups depending on the change in 6 MWT (responders > 30 m and nonresponders ≤ 30 m). Logistic regression analysis was used. Results. After PR, 6 MWT performance all outcome measures significantly improved (P < 0.01). Compared to nonresponders (N = 38), the responders (N = 37) had lower values in baseline lung function (P < 0.01). Logistic regression analysis showed that FEV1 < 50% pred and TL, CO < 50% pred were independent predictors of PR efficacy.


CONCLUSIONS
Our study shows that in stable moderate-to-severe complex COPD inpatients, baseline lung function may predict the response to PR in terms of 6 MWT. We also found that complex COPD patients with poor lung function get more benefit from PR.
Division of Pneumology, IRCCS Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, via Roncaccio 16, 21049 Tradate, Italy ; Department of Clinical and Experimental Medicine, University of Insubria, via Ravasi 2, 21100 Varese, Italy.
Andrea
A
Zanini
Respiratory Disease and Lung Function Unit, Department of Clinical and Experimental Medicine, University of Parma, Padiglione Rasori, via Rasori 10, 43125 Parma, Italy.
Alfredo
A
Chetta
Division of Pneumology, IRCCS Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, via Roncaccio 16, 21049 Tradate, Italy.
Federico
F
Gumiero
Division of Pneumology, IRCCS Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, via Roncaccio 16, 21049 Tradate, Italy.
Sabrina
S
Della Patrona
Division of Pneumology, IRCCS Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, via Roncaccio 16, 21049 Tradate, Italy.
Silvia
S
Casale
Division of Pneumology, IRCCS Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, via Roncaccio 16, 21049 Tradate, Italy.
Elisabetta
E
Zampogna
Respiratory Disease and Lung Function Unit, Department of Clinical and Experimental Medicine, University of Parma, Padiglione Rasori, via Rasori 10, 43125 Parma, Italy.
Marina
M
Aiello
Division of Pneumology, IRCCS Rehabilitation Institute of Tradate, Salvatore Maugeri Foundation, via Roncaccio 16, 21049 Tradate, Italy ; Department of Clinical and Experimental Medicine, University of Insubria, via Ravasi 2, 21100 Varese, Italy.
Antonio
A
Spanevello
D000368:Aged; D001784:Blood Gas Analysis; D004417:Dyspnea / Q000503:physiopathology; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000473:pathology / Q000534:rehabilitation* / Q000628:therapy*; D012189:Retrospective Studies; D013147:Spirometry; D016896:Treatment Outcome; D016138:Walking