1. Power of Outcome Measurements to Detect Clinically Significant Changes in Pulmonary Rehabilitation of Patients With COPD.
- Author
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de Torres, Juan Pablo, Pinto-Plata, Victor, Ingenito, Edward, Bagley, Peter, Gray, Anthony, Berger, Robert, and Celli, Bartolome
- Subjects
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OBSTRUCTIVE lung disease treatment , *QUALITY of life - Abstract
Study objectives: Several validated instruments are used to measure outcomes, such as exercise performance, dyspnea, and health-related quality of life after pulmonary rehabilitation (PR) in patients with COPD. However, no study has simultaneously compared the responsiveness of the most frequently used outcome measurements after PR. We designed this study to investigate the capacity of several of the most frequently used outcome measurements to detect changes after PR in a population of patients with severe COPD who qualified for lung volume reduction surgery. Design, patients, and interventions: We evaluated 37 patients with severe COPD (FEV[sub 1] < 40%) before and after 6 to 8 weeks of outpatient PR. The following frequently used tools were evaluated: the 6-min walk distance (6MWD); functional dyspnea with the Medical Research Council (MRC) scale; baseline and transitional dyspnea index (BDI/TDI); resting and 6MWD visual analog scale (VAS); quality of life with a generic tool (the Short Form-36 [SF-36]); and two disease-specific tools, the Chronic Respiratory Disease Questionnaire (CRQ) and the St. George's Respiratory Questionnaire (SGRQ). Results: After PR, mean ± SD 6MWD increased in 33 of 37 patients (89%), from 285 ± 97 to 343 ± 92 m (p = 0.009). Improvements were seen also in the MRC scale in 23 of 37 patients (62%; from 2.27 ± 0.8 to 1.86 ± 0.6; p = 0.01); in CRQ dyspnea in 25 of 37 patients (67%; from 3.25 ± 0.9 to 3.90 ± 1.4; p = 0.02); in CRQ mastery in 22 of 37 patients (60%; from 4.37 ± 1.4 to 5.14 ± 1.3; p = 0.01); and in BDUTDI functional in 24 of 37 patients (64%; from 1.4 ± 0.8 to 0.7 ± 1.1; p = 0.002). There were smaller improvements in the SGRQ in 18 of 37 patients (48%) and in the SF-36 in 19 of 37 patients (51%), but they were not statistically significant. There were good correlations between the dyspnea components of all the tools. The 6MWD change did not... [ABSTRACT FROM AUTHOR]
- Published
- 2002
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