Determination of exacerbation predictors in patients with COPD in physical therapy - a longitudinal study.
BACKGROUND
Chronic obstructive pulmonary disease (COPD) typically presents the characteristic clinical condition of exacerbation, with more intense symptoms associated with greater functional loss and consequently lower chances of patient survival.


OBJECTIVE
This study sought to determine the predictors of exacerbation, alone or in combination, in patients with chronic obstructive pulmonary disease (COPD) who received physical therapeutic treatment over 6 months.


METHODS
This was an observational, longitudinal and prospective study in which 63 COPD patients residing within the municipality of São Carlos, SP, Brazil were evaluated. These patients had COPD stages II and III and were entered into a physical therapy program, consisting of 3 periods of assessment over 6 months. We evaluated the occurrence of acute exacerbation as well as the patients' body mass index (BMI), fat-free mass (FFM), fat-free mass index, forced expiratory volume in 1 second (FEV1), dyspnea, distance walked (DW) in the 6-minute walk test (6MWT) and handgrip strength.


RESULTS
When applying Cox settings with each covariate separately, the results revealed 5% significance only for the DW in the 6MWT, which demonstrated an interaction between BMI and FFM. Comparison of the 3 periods of assessment across the covariates measured showed a significant difference only for the DW between evaluations in the 3rd and 6th months.


CONCLUSIONS
Upon analyzing the predictors of risk over 6 months of follow-up in patients with COPD, we found that the DW in the 6MWT was associated with the risk of exacerbation, although this risk also depended on the covariates BMI and FFM.
Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
Diego M
DM
Marino
Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
Kamilla T
KT
Marrara
Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
Juliano F
JF
Arcuri
Department of Statistics, UFSCar, São Carlos, SP, Brazil.
Cecília
C
Candolo
Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
Maurício
M
Jamami
Department of Physical Therapy, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
Valéria A Pires
VA
Di Lorenzo
D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*