title: Response of the COPD Assessment Tool in Stable and Postexacerbation Pulmonary Rehabilitation Populations.
abstract: OBJECTIVE
  The COPD Assessment Tool (CAT) has previously been shown to be a sensitive outcome measure for pulmonary rehabilitation (PR) in a stable population, but its utility in a postexacerbation PR population is unknown. The aim of this study was to investigate any differences in response to the CAT between stable and postexacerbation patients undertaking PR.
  
  
  METHODS
  Patients attending a 7-week outpatient PR program completed a CAT questionnaire pre- and postrehabilitation. Patients referred for elective outpatient PR were compared with those who had been referred to PR following a hospital admission for an exacerbation.
  
  
  RESULTS
  Two hundred consecutive patients completed the CAT questionnaire: 125 stable patients (74 male, mean age 71.1 ± 8.9 years, forced expiratory volume in 1 second [FEV1] 1.39 L ± 0.6, and body mass index [BMI] 28.5 ± 6.7 kg/m) and 75 postexacerbation patients (23 male, mean age 70.6 ± 8.6 years, FEV1 1.16 L ± 0.5, and BMI 25.8 ± 7.3 kg/m). A statistically significant difference between the stable and postexacerbation patient groups pre-PR CAT score (P = .05) was observed. There was no significant difference in post-PR CAT scores or change in CAT scores between the stable and postexacerbation groups. There was a significant difference in pre- and post-PR walking test results between the groups. The improvement in the Endurance Shuttle Walking Test (ESWT) in the stable group was greater (P < .05).
  
  
  CONCLUSIONS
  Postexacerbation PR patients had a worse CAT score prior to PR when compared with a stable PR population, but both groups made improvements in CAT following completion of PR.
authors.affiliation: Centre for Exercise and Rehabilitation Science, NIHR Leicester Respiratory BRU, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom (Ms Chaplin); Pulmonary Rehabilitation Department, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom (Ms Gibb and Drs Sewell and Singh); and Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom (Dr Singh).
authors.forename: Emma
authors.initials: E
authors.lastname: Chaplin
authors.forename: Michelle
authors.initials: M
authors.lastname: Gibb
authors.forename: Louise
authors.initials: L
authors.lastname: Sewell
authors.forename: Sally
authors.initials: S
authors.lastname: Singh
mesh_terms: D000368:Aged; D005080:Exercise Test / Q000706:statistics & numerical data; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D010045:Outpatients / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D015203:Reproducibility of Results; D012129:Respiratory Function Tests / Q000706:statistics & numerical data; D012189:Retrospective Studies; D011795:Surveys and Questionnaires / Q000592:standards*