Functional capacity variation after pulmonary rehabilitation in COPD patients – A survival predictor

Abstract

Introduction: Functional capacity measured by the six-minute walk test (6MWD) is associated with exacerbations and mortality in COPD.An increase in 6MWD has been demonstrated post Pulmonary Rehabilitation Programs (PRP). Objectives: Determine 6MWD variation after PRP in COPD patients and evaluate its impact in 4-year mortality. Methods: COPD patients that completed a PRP between 2008-2011 were included.6MWD pre and post PRP was recorded.6MWD variation was associated with baseline demographic data, symptoms, comorbidities, pulmonary function and mortality. Results: 138 COPD patients were included with a male predominance and a mean age of 65 years.Mean 6MWD pre and post PRP was 348±101 and 393±121 meters, respectively, with a mean increase of 45±5 meters ( p p 0.014), in those with respiratory failure receiving Long Term Oxygen Therapy ( p 0.03) and in those with a 6MWD pre PRP lower than 350 meters ( p 0.012).The deceased group had a lower gain in functional exercise capacity after PRP (29±14 vs 49±7 meters).An increase in 6MWD after PRP lower than 25 meters was associated with lower survival in this study. Conclusion: Mortality may be associated with a lower gain in functional capacity after Pulmonary Rehabilitation, emphasizing the role of exercise training in improving 6MWD, which might have impact in survival.