Relationships Between Forced Oscillatory Impedance and 6-minute Walk Distance After Pulmonary Rehabilitation in COPD
| Autor: | Amy Bertolin, Cindy Thamrin, David G. Chapman, Gregory G. King, Andrew S. L. Chan, Sabine C. Zimmermann |
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| Rok vydání: | 2020 |
| Předmět: |
Spirometry
medicine.medical_specialty COPD Rehabilitation medicine.diagnostic_test business.industry medicine.medical_treatment General Medicine medicine.disease 03 medical and health sciences FEV1/FVC ratio 0302 clinical medicine 030228 respiratory system Quality of life Internal medicine Cardiology medicine Plethysmograph Pulmonary rehabilitation Lung volumes 030212 general & internal medicine business |
| Zdroj: | International Journal of Chronic Obstructive Pulmonary Disease. 15:157-166 |
| ISSN: | 1178-2005 |
| DOI: | 10.2147/copd.s225543 |
| Popis: | Rationale Pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) reduces dyspnoea and improves exercise capacity and quality of life. The improvement in exercise capacity is variable and unpredictable, however. Respiratory system impedance obtained by forced oscillation technique (FOT) as a measure of ventilatory impairment in COPD may relate to improvement in exercise capacity with pulmonary rehabilitation. We aimed to determine if baseline FOT parameters relate to changes in exercise capacity following pulmonary rehabilitation. Methods At the start of rehabilitation, 15 COPD subjects (mean(SD) 75.2(6.1) years, FEV1 z-score -2.61(0.84)) had measurements by FOT, spirometry, plethysmographic lung volumes and 6-minute walk distance (6MWD). Respiratory system resistance (Rrs) and reactance (Xrs) parameters as the mean over all breaths (Rmean, Xmean), during inspiration only (Rinsp, Xinsp), and expiratory flow limitation (DeltaXrs = Xinsp-Xexp), were calculated. FOT and 6MWD measurements were repeated at completion of rehabilitation and 3 months after completion. Results At baseline, Xrs measures were unrelated to 6MWD. Xinsp improved significantly with rehabilitation (from mean(SD) -2.35(1.02) to -2.04(0.85) cmH2O.s.L-1, p=0.008), while other FOT parameters did not. No FOT parameters related to the change in 6MWD at program completion. Baseline Xmean, DeltaXrs, and FVC z-score correlated with the change in 6MWD between completion and 3 months after completion of rehabilitation (rs=0.62, p=0.03; rs=-0.65, p=0.02; and rs=0.62, p=0.03, respectively); with worse ventilatory impairment predicting loss of 6MWD. There were no relationships between Rrs parameters, FEV1 or FEV1/FVC z-scores and changes in 6MWD. Conclusion Baseline reactance parameters may be helpful in predicting those patients with COPD at most risk of loss of exercise capacity following completion of pulmonary rehabilitation. |
| Databáze: | OpenAIRE |
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