Baseline characteristics associated to improvement of patients with COPD in physical activity in daily life level after pulmonary rehabilitation - 30/04/19
, Anelise Bauer Munari a, b , Isabela Júlia Cristiana Santos Silva a , Hellen Fontão Alexandre a, c , Manuela Karloh a , Anamaria Fleig Mayer a, b, c, ⁎ Abstract |
Background |
Knowing the patients with chronic obstructive pulmonary disease (COPD) that increase the physical activity of daily living (PADL) after pulmonary rehabilitation (PR) is a challenge. Aims: to compare baseline characteristics between patients who achieved and failed to achieve the minimal important difference (MID) of PADL post-PR; to verify which baseline variables better predict the change and identify a cut-off point to discriminate MID achievers.
Methods |
Fifty-three patients with COPD (FEV1: 38.3; 95%CI 34.4–42.2%pred) were evaluated for spirometry, dyspnea, quality of life, functional capacity, mortality risk and PADL level. After 24 sessions of PR had their PADL level revaluated.
Results |
The MID achievers presented lower FEV1, functional capacity, time walking, number of steps, active time, energy expenditure (EE) walking, time on PADL≥3 metabolic equivalent of task (METs) and higher time on PADL<1.5MET. Inactive patients and with severe physical inactivity presented a hazard ratio of 4.27 and 6.90 (95%CI: 1.31–13.9, p = 0.02; 95%CI: 1.99–23.9, p = 0.002; respectively) for achieving the MID. The variables of predictive model for the change in the PADL were EE walking and time on PADL<1.5MET (R2: 0.37; p = 0.002). The cut-off point of 6525 steps [sensitivity = 95%; specificity = 61%; AUC = 0.82 (95%CI: 0.71–0.93), p < 0.001] was able to discriminate patients who achieved and failed to achieve the MID.
Conclusion |
Patients with worse lung function, functional capacity and lower PADL level before PR are those that improve the PADL level. EE walking and time on PADL<1.5MET better predict this change. The cut-off point of 6525 steps can help to identify patients with higher chances of improving the PADL level.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Patients who improve the level of physical activity have worse pulmonary function. |
• | Patients who improve the level of physical activity have worse functional capacity. |
• | Patients who improve their level of physical activity are physically inactive. |
• | The level of physical activity basal is the best predictor of their change. |
• | The cut off point of 6525 basal steps could identify the improvement of patients. |
Keywords : Pulmonary disease, Chronic obstructive, Physical activity, Minimal clinically important difference, Exercise therapy
Plan
Vol 151
P. 142-147 - mai 2019 Retour au numéro
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