Validity of the six-minute walked distance change after rehabilitation in a unselected cohort of COPD
E. M. Clini, E. Crisafulli, S. Costi, G. Rossi, L. Trianni, C. Lorenzi, S. Lucic, R. D‘Amico, L. M. Fabbri, N. Ambrosino (Modena, Pavullo (MO), Pisa, Italy)
Source: Annual Congress 2008 - Physiological response to exercise performance
Session: Physiological response to exercise performance
Session type: E-Communication Session
Number: 3288
Disease area: Airway diseases
Abstract Six-minute walking distance (6MWD) has been so far recognised as a useful tool to assess changes after rehabilitation (PR) in COPD patients. A change of +54 (range 31 to 70) meters has been proposed as the clinically meaningful variation (MCID) after treatment. Patients who are able to reach the threshold limit of ≥350 m are likely to live longer. To assess the validity of change in 6MWD in a unselected cohort of COPD, we have retrospectively reviewed data sets of 1938 COPD (73% male, age 70±8 yrs, FEV1 50±16 %pred.) referred for PR. Patients were divided into categories according to the disability MRC grade (1 to 5) recalled at baseline. Six patients in MRC-1 category were excluded from analysis.Changes in 6MWD, perceived dyspnoea at peak exercise (by BORG scale), and self-reported quality of life (by SGRQ) were then assessed throughout the program. After PR, the absolute change in 6MWD (52 [95%CI 45 to 59], 65 [95%CI 60 to 70], 63 [95%CI 59 to 66], and 70 [95%CI 67 to 74] meters in MRC-2 to 5 respectively) and the % of patients achieving the MCID (40, 54, 56, and 61% in MRC-2 to 5 respectively) were significantly different (p=0.001) across categories. Interestingly, the proportion of patients reaching the limit of ≥350 m at the 6MWD increased according to MRC categories (7, 18, 23, and 25% respectively) after PR. No correlations were found among changes in the considered outcomes. We conclude that change in 6MWD provides effectiveness of rehabilitation across all MRC categories. After rehabilitation, the proportion of patients reaching the MCID and the limit of ≥350 m increased according to the MRC grade.
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E. M. Clini, E. Crisafulli, S. Costi, G. Rossi, L. Trianni, C. Lorenzi, S. Lucic, R. D‘Amico, L. M. Fabbri, N. Ambrosino (Modena, Pavullo (MO), Pisa, Italy). Validity of the six-minute walked distance change after rehabilitation in a unselected cohort of COPD. Eur Respir J 2008; 32: Suppl. 52, 3288
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