Predictors of success of pulmonary rehabilitation

Le résumé fourni par la source

Pulmonary rehabilitation program (PR) is an important part of comprehensive treatment of patients with chronic pulmonary diseases. Patients physical improvement after PR varies. Aim of study was to identify potential predictors of success of PR. We included 121 patients with chronic obstructive pulmonary disease (COPD) who completed 4-week inpatient PR in University Clinic of Respiratory and Allergic Diseases Golnik without exacerbations of disease that could potentially affect PR outcomes. Improvement in distance ≥ 30 m on the 6-minute walk test (6MWT) after PR was chosen as a primary marker of physical success. We compared baseline clinical characteristics, lung function, physical capacity, body composition, and laboratory blood tests between group of good and poor responders. 91 patients were good responders and 30 poor responders. Good responders had higher body weight (77.4 ± 19.2 kg vs 69.5 ± 15.3 kg, p = 0.036), body fat content (26.6 ± 9.0 kg vs 23.4 ± 8.3 kg, p = 0.049), dry lean mass (11.7 ± 5.2 kg vs 9.3 ± 4.3 kg, p = 0.021), reduced content of water (51.3 ± 6.5 % vs 54.4 ± 7.6 %, p = 0.042), higher haemoglobin levels (145.6 ± 13.7 g/L vs 139.7 ± 11.6 g/L, p = 0.040), erythrocytes count (4.68 ± 0.47 × 1012/L vs 4.48 ± 0.45 × 1012/L, p = 0.017), haematocrit (0.43 ± 0.03 L/L vs 0.41 ± 0.03 L/L, p = 0.030) and serum iron (19.65 ± 7.67 µmol/L vs 16.79 ± 6.45 µmol/L, p = 0.028). Heavier COPD patients (more fat and muscles) with higher ability to transport oxygen from the blood to the muscles can gain more physical improvement from PR. We suggest that in sarcopenic and/or anaemic patients, before referral to PR, care should be taken to address and remedy their condition first to maximise their physical gain with PR.

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