School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Western Australia, Australia (Ms Ho and Drs Jenkins, Eastwood, Cavalheri, and Hill); Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia (Drs Alison, Wootton, and McKeough); Sydney Local Health District, New South Wales, Australia (Drs Alison and Spencer); Physiotherapy Department, Singapore General Hospital, Singapore (Dr Ng); Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, New South Wales, Australia (Dr Wootton); Institute for Respiratory Health (Drs Jenkins, Eastwood, Cavalheri, and Hill), Physiotherapy Department (Dr Jenkins), and Department of Pulmonary Physiology & Sleep Medicine (Drs Eastwood and Hillman), Sir Charles Gairdner Hospital, Western Australia, Australia; Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Western Australia, Australia (Dr Eastwood); and Department of Thoracic Medicine, Concord Hospital, Concord, New South Wales, Australia (Dr Jenkins).
J Cardiopulm Rehabil Prev. 2019 Sep;39(5):338-343. doi: 10.1097/HCR.0000000000000421.
To investigate the characteristics that distinguish responders from nonresponders to ground-based walking training (GBWT) in people with chronic obstructive pulmonary disease (COPD).
An analysis was undertaken of data collected during a trial of GBWT in people with COPD. Responders to GBWT were defined in 2 ways: (1) improved time on the endurance shuttle walk test of ≥190 sec (criterion A); or (2) improved ability to walk, perceived by the participant to be at least "moderate" (criterion B). Differences in participant characteristics, pre-training exercise capacity, health-related quality of life, and the improvement in the distance walked during the training program were examined between responders and nonresponders.
Of the 95 participants randomized to GBWT (age 69 ± 8 yr, forced expiratory volume in 1 sec [FEV1] % predicted = 43% ± 15%), data were available for analysis on 78 and 73 patients by criterion A and criterion B, respectively. According to criterion A, 32 (41%) participants were responders. The odds of being a responder increased with increasing FEV1 % predicted (OR = 1.2; 95% CI, 1.0-1.5, for every 5% increase) and increased with decreasing pre-training incremental shuttle walk distance (OR = 1.4; 95% CI, 1.0-1.8, for every 50-m decrement). According to criterion B, 42 (58%) participants were responders. There were no differences in characteristics or pre-training measures between the responders and nonresponders. For both criteria, responders demonstrated greater change in the distance walked during the training program (P < .05).
Responders to GBWT had lower pre-training exercise capacity, had better lung function, and demonstrated greater change in the distance walked during the training program.
探究能够区分慢性阻塞性肺疾病（COPD）患者对基于地面行走训练（GBWT）有反应者和无反应者的特征。
对一项 COPD 患者 GBWT 试验中收集的数据进行了分析。通过两种方式定义对 GBWT 有反应者：（1）耐力穿梭步行测试的时间增加≥190 秒（标准 A）；或（2）参与者认为行走能力至少“中度”改善（标准 B）。比较了有反应者和无反应者之间的参与者特征、训练前运动能力、健康相关生活质量以及训练计划中行走距离的改善情况。
95 名随机分配至 GBWT 的参与者（年龄 69±8 岁，1 秒用力呼气量占预计值百分比[FEV1%pred] = 43%±15%）中，有 78 名和 73 名患者可根据标准 A 和标准 B 进行数据分析。根据标准 A，32 名（41%）患者为有反应者。FEV1%pred 每增加 5%（OR = 1.2；95%CI，1.0-1.5）和训练前递增穿梭步行距离每减少 50m（OR = 1.4；95%CI，1.0-1.8），成为有反应者的可能性会增加。根据标准 B，42 名（58%）患者为有反应者。有反应者和无反应者之间的特征或训练前测量值没有差异。对于两个标准，有反应者在训练期间行走距离的变化更大（P<.05）。
对 GBWT 有反应者的训练前运动能力较低，肺功能较好，并且在训练期间行走距离的变化更大。
