Chaplin Emma, Gibb Michelle, Sewell Louise, Singh Sally
Centre for Exercise and Rehabilitation Science, NIHR Leicester Respiratory BRU, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom (Ms Chaplin); Pulmonary Rehabilitation Department, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom (Ms Gibb and Drs Sewell and Singh); and Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom (Dr Singh).
J Cardiopulm Rehabil Prev. 2015 May-Jun;35(3):214-8. doi: 10.1097/HCR.0000000000000090.
The COPD Assessment Tool (CAT) has previously been shown to be a sensitive outcome measure for pulmonary rehabilitation (PR) in a stable population, but its utility in a postexacerbation PR population is unknown. The aim of this study was to investigate any differences in response to the CAT between stable and postexacerbation patients undertaking PR.
Patients attending a 7-week outpatient PR program completed a CAT questionnaire pre- and postrehabilitation. Patients referred for elective outpatient PR were compared with those who had been referred to PR following a hospital admission for an exacerbation.
Two hundred consecutive patients completed the CAT questionnaire: 125 stable patients (74 male, mean age 71.1 ± 8.9 years, forced expiratory volume in 1 second [FEV1] 1.39 L ± 0.6, and body mass index [BMI] 28.5 ± 6.7 kg/m) and 75 postexacerbation patients (23 male, mean age 70.6 ± 8.6 years, FEV1 1.16 L ± 0.5, and BMI 25.8 ± 7.3 kg/m). A statistically significant difference between the stable and postexacerbation patient groups pre-PR CAT score (P = .05) was observed. There was no significant difference in post-PR CAT scores or change in CAT scores between the stable and postexacerbation groups. There was a significant difference in pre- and post-PR walking test results between the groups. The improvement in the Endurance Shuttle Walking Test (ESWT) in the stable group was greater (P < .05).
Postexacerbation PR patients had a worse CAT score prior to PR when compared with a stable PR population, but both groups made improvements in CAT following completion of PR.
慢性阻塞性肺疾病评估工具（CAT）先前已被证明是稳定人群肺康复（PR）的敏感结局指标，但它在急性加重后PR人群中的效用尚不清楚。本研究的目的是调查稳定期和急性加重后接受PR的患者在CAT反应上的任何差异。
参加为期7周门诊PR项目的患者在康复前后完成了CAT问卷。将择期门诊PR患者与因急性加重住院后转诊至PR的患者进行比较。
200例连续患者完成了CAT问卷：125例稳定期患者（74例男性，平均年龄71.1±8.9岁，第1秒用力呼气量[FEV1]1.39 L±0.6，体重指数[BMI]28.5±6.7 kg/m²）和75例急性加重后患者（23例男性，平均年龄70.6±8.6岁，FEV1 1.16 L±0.5，BMI 25.8±7.3 kg/m²）。观察到稳定期和急性加重后患者组PR前CAT评分存在统计学显著差异（P = 0.05）。稳定期和急性加重后组PR后CAT评分或CAT评分变化无显著差异。两组之间PR前后步行测试结果存在显著差异。稳定组耐力穿梭步行测试（ESWT）的改善更大（P < 0.05）。
与稳定期PR人群相比，急性加重后PR患者在PR前的CAT评分更差，但两组在完成PR后CAT均有改善。
