Queensland Lung Transplant Service, The Prince Charles Hospital, Brisbane, QLD 4032, Australia.
J Cardiopulm Rehabil Prev. 2013 Jul-Aug;33(4):249-56. doi: 10.1097/HCR.0b013e31829501b7.
The study aims were (1) to determine whether baseline measures-including the Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) index; Age, Dyspnea, and Airflow Obstruction (ADO) index; physical activity; comorbidities (cardiac, metabolic, or musculoskeletal disease); and the number of hospitalizations over the previous 12 months-can predict responders in 6-minute walk distance (6MWD) following pulmonary rehabilitation (PR) and (2) to determine whether different methods in defining improvement in 6MWD affected identifying responders to PR.
All participants with chronic obstructive pulmonary disease who attended PR at our institution between 2004 and 2009 were evaluated. A participant was classified as a responder with improvement in 6MWD (≥25 m or ≥2 SD of this dataset coefficient of repeatability).
A total of 203 participants (mean age, 68.2 ± 8.7 years; mean predicted forced expiratory volume in 1 second, 52.5 ± 22.4%) were analyzed. One hundred twenty participants (59.1%) had a comorbidity categorized as cardiac, metabolic, or musculoskeletal disease. The binary logistic regression models showed that younger participants (P ≤ .015) and, when using the coefficient of repeatability method (≥60.9 m), participants with metabolic disease (P = .040) were the only independent predictors of response. No other measure, including participant BODE or ADO index scores, contributed to either model.
Identifying responders in exercise capacity following PR remains difficult, with only age and participants with metabolic disease identified as independent predictors.
本研究旨在：（1）确定基线指标，包括体重指数、气流阻塞、呼吸困难和运动能力（BODE）指数、年龄、呼吸困难和气流阻塞（ADO）指数、体力活动、合并症（心脏、代谢或肌肉骨骼疾病）以及前 12 个月的住院次数，是否可以预测肺康复（PR）后 6 分钟步行距离（6MWD）的反应者；（2）确定 6MWD 改善定义的不同方法是否影响 PR 反应者的识别。
评估了 2004 年至 2009 年间在我们机构接受 PR 的所有慢性阻塞性肺疾病患者。将 6MWD 改善（≥25m 或≥该数据集重复性系数的 2SD）的患者定义为反应者。
共分析了 203 名参与者（平均年龄 68.2±8.7 岁；平均预测 1 秒用力呼气量 52.5±22.4%）。120 名参与者（59.1%）有心脏、代谢或肌肉骨骼疾病等合并症。二元逻辑回归模型显示，年龄较小的参与者（P≤0.015）和使用重复性系数方法（≥60.9m）的参与者患有代谢疾病（P=0.040）是反应的唯一独立预测因素。其他指标，包括参与者的 BODE 或 ADO 指数评分，都没有为这两个模型做出贡献。
在 PR 后运动能力方面，反应者的识别仍然困难，只有年龄和患有代谢疾病的参与者被确定为独立预测因素。
