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Title: The likelihood of improving physical activity after pulmonary rehabilitation is increased in patients with COPD who have better exercise tolerance.
Austin Authors: Osadnik, Christian R;Loeckx, Matthias;Louvaris, Zafeiris;Demeyer, Heleen;Langer, Daniel;Rodrigues, Fernanda M;Janssens, Wim;Vogiatzis, Ioannis;Troosters, Thierry
Affiliation: Institute for Breathing and Sleep
Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
Monash Lung and Sleep, Monash Health, Melbourne, Victoria, Australia
Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
Respiratory Division, University Hospitals, KU Leuven, Leuven, Belgium
Faculty of Physical Education and Sports Sciences, National and Kapodistrian University of Athens, Athens, Greece
Department of Chronic Disease, Metabolism and Aging, KU Leuven, Leuven, Belgium
Department of Physiotherapy, LUNEX International University of Health, Exercise and Sports, Differdange, Luxembourg
Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle upon Tyne, UK
Issue Date: 24-Oct-2018
Date: 2018
Publication information: International journal of chronic obstructive pulmonary disease 2018; 13: 3515-3527
Abstract: Pulmonary rehabilitation (PR) enhances exercise tolerance in patients with COPD; however, improvements in physical activity (PA) are not guaranteed. This study explored the relationship between baseline exercise tolerance and changes in PA after PR. Patient data from prospective clinical trials in the PR settings of Athens and Leuven (2008-2016) were analyzed. Validated PA monitors were worn for 1 week before and after a 12-week program. The proportion of patients who improved PA levels ≥1,000 steps/day ("PA responders") after PR was compared between those with initial 6-minute walk distance [6MWDi] <350 m and ≥350 m. Baseline predictors of PA change were evaluated via univariate and multivariate logistic regression analyses. Two hundred thirty-six patients with COPD (median [IQR] FEV1 44 [33-59] % predicted, age 65±8 years, 6MWDi 416 [332-486] m) were included. The proportion of "PA responders" after PR was significantly greater in those with higher vs lower 6MWDi (37.9% vs 16.4%, respectively; P<0.001). 6MWDi group classification was the strongest baseline independent predictor of PA improvement (univariate OR 3.10, 95% CI 1.51-6.36). The likelihood of improving PA after PR is increased with greater 6MWDi. Baseline exercise tolerance appears as an important stratification metric for future research in this field.
DOI: 10.2147/COPD.S174827
ORCID: 0000-0001-9040-8007
Journal: International journal of chronic obstructive pulmonary disease
PubMed URL: 30498342
PubMed URL:
Type: Journal Article
Subjects: COPD
clinical respiratory medicine
exercise and pulmonary rehabilitation
physical activity
responder analysis
Appears in Collections:Journal articles

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