Cough in pulmonary rehabilitation: a retrospective analysis of responders/non-responders

Abstract

Pulmonary rehabilitation (PR) is essential for people with chronic respiratory diseases (CRD), yet its impact on cough-related quality of life (CR-QoL) remains unexplored. We assessed the PR effects on CR-QoL, described the characteristics of responders and non-responders to PR and explored determinants of responsiveness in this health domain in individuals with CRD.A retrospective study was conducted. We assessed CR-QoL using the Leicester Cough Questionnaire (LCQ) and the impact of the disease with the COPD Assessment Test (CAT), before and after PR. Cut-offs of <17.05 in LCQ total score and ≥10 in CAT were used to detect low CR-QoL and medium impact of the disease. Responders were defined as achieving a minimal clinically important difference (MCID) of ≥1.3 on the LCQ total score. Pre-post PR analysis involved t-test/Wilcoxon/McNemar tests and comparisons between groups included independent t /Mann-Whitney U/Fisher's exact tests. Logistic regression was employed to investigate factors influencing MCID achievement.135 participants with CRD (39%♀; 68±10 years old; 61% COPD; FEV1%predicted 62.6±23.0) were included. After PR, significant improvements were observed in all LCQ domains and CAT. 31% of participants were identified as responders in the LCQ (36%♀; 66±10 years; 62% COPD; FEV1%predicted 60.0±22.3) showcasing significant differences in LCQ and CAT compared to non-responders. People with low CR-QoL and/or medium/high impact of the disease at baseline were 11 and 4 times, more likely to respond to PR in CR-QoL, respectively.PR enhances CR-QoL. Identification of CR-QoL and disease impact traits at baseline offers insights to optimize this outcome responsiveness to PR.