Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Jun Horie; Koichiro Takahashi; Shuuichi Shiranita; Kunihiko Anami; Shinichiro Hayashi

doi:10.3390/healthcare9010053

Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1

Healthcare (Basel). 2021 Jan 6;9(1):53. doi: 10.3390/healthcare9010053.

Authors

Jun Horie¹, Koichiro Takahashi², Shuuichi Shiranita³, Kunihiko Anami⁴, Shinichiro Hayashi⁵

Affiliations

¹ Department of Physical Therapy, Faculty of Health Science, Kyoto Tachibana University, 34 Yamada-cho Oyake, Yamashina-ku, Kyoto 607-8175, Japan.
² Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga 840-8502, Japan.
³ Choseido-Watanabe Clinic, Department of Rehabilitation, 7182-58 Kaigandoori, Karatsu City, Saga 847-0873, Japan.
⁴ Department of Rehabilitation, Faculty of Health Sciences, Naragakuen University, 3-12-1 Sangou-cho Tatsunokita, Ikoma-gun, Nara 636-8503, Japan.
⁵ Department of Physical Therapy, School of Health Sciences at Fukuoka, Okawa Campus in Fukuoka Prefecture, International University of Health and Welfare, Okawa, 137-1 Enotsu, Okawa City, Fukuoka 831-8501, Japan.

Abstract

This study's objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx-patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV_1.0) <50%; (2) HiFlo + HiEx-patients with a 6MWD ≥350 m and a %FEV_1.0 ≥50%; (3) LoFlo + LoEx-patients with a 6MWD < 350 m and %FEV_1.0 < 50%; and (4) HiFlo + LoEx-patients with a 6MWD <350 m and %FEV_1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George's Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups.

Keywords: COPD management; chronic obstructive pulmonary disease; exercise tolerance; forced expiratory volume; rehabilitation.

Grants and funding

JP25350650/JSPS KAKENHI