Abstract
Background: Exercise training is a core component of pulmonary rehabilitation programmes (PRP). In addition to characterising patient limitations, pre-PRP cardiopulmonary exercise testing (CEPT) can be used to screen for adverse effects of exercise, such as ischaemia, arrhythmia, or hypoxaemia, and to design individual exercise training regimens that are effective and tolerable. This study aimed to investigate the impact of pre-PRP CPET on outcomes Methods: Screened patients with COPD were invited to participate in PRP at a local acute hospital in Hong Kong. Patients with contraindications to exercise were excluded. Eligible patients were arranged to undergo CPET before training. Positive outcomes were defined as improvement in St George’s Respiratory Questionnaire (SGRQ) score by four points or greater and/or improvement in 6-minute walk test (6MWT) distance by 30 m or more. Findings: 70 patients were recruited, 40 (57.1%) of whom achieved positive outcomes after training. More patients who had exercise testing (29 of 42; 69%) than those who did not have exercise testing (13 of 42; 31%) attained positive outcomes (p=0.014). All participants attained a training intensity close to the exercise testing determined target. Participants with positive outcome attained training intensity at 97.64±45.77% of their target; participants without positive outcome attained a lower training intensity at 87.10±21.90% of their target. Interpretation: This study shows that CPET was effective in helping PRP participants achieve positive outcomes. Whether the performance of patients without exercise testing had been limited by undiagnosed underlying medical condition was uncertain. Further studies exploring the impact of pre-PRP CPET in improving the safety and effectiveness of PRP are warranted. Funding: None. Contributors: CMC was responsible for data collection and analysis. Other authors were responsible for giving expert opinion. Conflicts of interest: We declare that we have no conflicts of interest.
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