Benefits of pulmonary rehabilitation in COPD patients; characterisation of the responders

Abstract

Pulmonary rehabilitation (PR) has known benefits, but variable for individual patients. The aim was to assess the benefits of a PR program and to study the characteristics of the responding patients. 16 COPD patients (pt) mean FEV1 49% were evaluated before and after a PR program: segmental body composition, 6MWT and cardiopulmonary exercise testing (CPET), quality of life tests: mMRC scale, CAT and St George9s Respiratory Questionnaire (SGRQ). Responders in exercise capacity were defined as having a 25 m increase in 6MWD or a 5W increase in maximal power at CPET. Responders in quality of life were defined as having a decrease of 1, 2 and 4 points respectively for mMRC, CAT or SGRQ. For each test the responders were compared with nonresponders in their initial parameters. Every patient had a benefit for at least one assessed parameter. 13 pt were responders in exercise capacity: 43% in 6WMT and 62% for CPET. 11 pt were responders in quality of life: 37% for mMRC, 62% for CAT, 50% for SGRQ. The responders for the 6MWT had a more severe SGRQ score than nonresponders (p 0.039). The responders for CPET had greater leg lean mass (p 0.043), fat free mass and skeletal muscle mass than nonresponders. The responders for SGRQ had greater mMRC and CAT scores than nonresponders. The responders for CAT score had greater CAT score, as the mMRC responders who had greater mMRC scores than nonresponders. Conclusions: Every patient had a benefit for at least one assessed parameter. 81 % of them improved their exercise capacity, with the responders for CPET having a greater muscular mass than nonresponders. 68% of the patients improved in quality of life scores. with the responders more disabled than nonresponders.