Changes in Exercise Capacity and Health-Related Quality of Life at Four and Eight Weeks of a Pulmonary Rehabilitation Program in People with COPD

Figures & data

Table 1. Baseline characteristics.

	All	GOLD grade II	GOLD grade III/IV
Variable	n = 50	n = 24	n = 26
Age, years	70 (7)	70 (8)	70 (6)
Sex (Male: Female)	30:20	14:10	16:10
BMI, kg/m^2	26 (5)	28 (5)	24 (5)
FEV1, % predicted	49 (17)	63 (9)	35 (9)
GOLD grade
II - Moderate	24	24	0
III - Severe	16	0	16
IV - Very Severe	10	0	10
Smoking status
Previous	40	20	20
Current	9	4	5
Never	1	0	1
Smoking pack years, years	41 (25)	44 (30)	39 (19)

Key: Results are recorded as means and standard deviation (SD); BMI, body mass index; FEV₁, forced expiratory volume in one second; kg, kilogram; m, metre; n, number; GOLD grades (moderate 50-79 FEV₁%predicted, severe 30-49 FEV₁%predicted, very severe <30 FEV₁%predicted).

Figure 1. a and 1b. Improvement in endurance shuttle walk test time during an eight-week pulmonary rehabilitation program. Participants were assessed at baseline (week 0), week four and week eight. Standard error bars are included.

Table 2. Outcome measures at baseline, week four and week eight.

	Baseline Mean (SD)	Week 4 Mean (SD)	Week 8 Mean (SD)	ANOVA p-value
ESWT, n = 46
Time, seconds	420 (231)	617 (389)	712 (400)	0.000*
6MWD, n = 47
Distance, metres	433 (102)	454 (94)	464 (107)	0.000*
CAT, n = 48
Score	18 (6)	17 (8)	16 (7)	0.005*
HADS, n = 47
Anxiety	7 (4)	6 (4)	7 (4)	0.509
Depression	5 (3)	5 (3)	5 (3)	0.673
SGRQ, n = 45
Symptoms	57 (23)	51 (20)	47 (22)	0.001*
Impact	30 (13)	28 (16)	26 (16)	0.040*
Activity	59 (18)	55 (19)	55 (20)	0.073
Total Score	43 (13)	39 (15)	38 (15)	0.005*

Key: All data are represented as raw mean (SD). *p < 0.05; 6MWD, 6-minute walk distance; CAT, COPD Assessment Test (out of 40, higher scores indicate higher impact of COPD); ESWT, endurance shuttle walk test; HADS, Hospital Anxiety and Depression Scale (out of 21, higher scores indicate higher likelihood of depression and/or anxiety); m, metres; n, number; SGRQ, St. George’s Respiratory Questionnaire (out of 100, higher scores indicate poorer health).

Table 3. Differences between measurement time points.

	Week 4 – baseline Mean difference (95%CI)	Week 8 – week 4 Mean difference (95%CI)	Week 8 – baseline Mean difference (95%CI)
ESWT, n = 46
Time, seconds	197 (89, 305)*	94 (8, 181)*	291 (179, 404)*
6MWD, n = 47
Distance, metres	22 (8, 36)*	9 (-4, 22)	31 (17, 45)*
CAT, n = 48
Score	−1 (-3, 0)	−1 (-2, 1)	−2 (-4, −1)*
HADS, n = 47
Anxiety	−1 (-2, −0.02)*	1 (-0.3, 2)	−0.3 (-2, 1)
Depression	−0.2 (-1, 1)	0 (-1, 1)	−0.2 (-1, 1)
SGRQ, n = 45
Symptoms	−6 (-12, −1)*	−4 (-9, 1)	−10 (-16, −5)*
Impact	−3 (-7, 1)	−1 (-5, 2)	−4 (-8, −0.2)*
Activity	−4 (-8, 0)	0 (-4, 4)	−4 (-8, 0)
Total Score	−4 (-7, −1)*	−1 (-4, 1)	−5 (-9, −2)*

Key: All data are represented as raw mean (SD). *p < 0.05; 6MWD, 6-minute walk distance; CAT, COPD Assessment Test (out of 40, higher scores indicate higher impact of COPD); ESWT, endurance shuttle walk test; HADS, Hospital Anxiety and Depression Scale (out of 21, higher scores indicate higher likelihood of depression and/or anxiety); m, metres; n, number; SGRQ, St. George’s Respiratory Questionnaire (out of 100, higher scores indicate poorer health).

Table 4. Outcome measures at baseline, week four and week eight by GOLD grade.

	n	Baseline Mean (SD)	Week 4 Mean (SD)	Week 8 Mean (SD)	ANOVA p-value
ESWT, seconds
GOLD II	22	461 (254)	679 (392)	742 (350)	0.002*
GOLD III/IV	24	383 (206)	561 (386)	684 (446)	0.001*
6MWD, metres
GOLD II	22	458 (101)	477 (90)	501 (102)	0.000*
GOLD III/IV	25	410 (100)	435 (94)	431 (102)	0.038*
CAT
GOLD II	23	18 (6)	16 (6)	15 (7)	0.037*
GOLD III/IV	25	19 (6)	18 (9)	17 (7)	0.071
HADS
Anxiety
GOLD II	23	7 (4)	6 (4)	6 (4)	0.600
GOLD III/IV	24	7 (4)	6 (4)	7 (4)	0.701
Depression
GOLD II	23	5 (2)	5 (3)	5 (3)	0.634
GOLD III/IV	24	6 (3)	5 (3)	6 (3)	0.936
SGRQ
Symptoms
GOLD II	23	54 (22)	50 (20)	47 (20)	0.061
GOLD III/IV	22	60 (23)	51 (20)	46 (24)	0.006*
Impact
GOLD II	23	31 (14)	25 (15)	25 (16)	0.021*
GOLD III/IV	22	30 (14)	30 (17)	28 (15)	0.524
Activity
GOLD II	23	55 (20)	49 (19)	50 (22)	0.102
GOLD III/IV	22	63 (15)	61 (16)	60 (15)	0.403
Total
GOLD II	23	42 (14)	36 (14)	36 (16)	0.012*
GOLD III/IV	22	45 (13)	43 (15)	41 (13)	0.146

Key: All data are represented as raw mean (SD).

* p < 0.05; 6MWD, 6-minute walk distance; CAT, COPD Assessment Test (out of 40, higher scores indicate higher impact of COPD); ESWT, endurance shuttle walk test; HADS, Hospital Anxiety and Depression Scale (out of 21, higher scores indicate higher likelihood of depression and/or anxiety); m, metres; n, number; SGRQ, St. George’s Respiratory Questionnaire (out of 100, higher scores indicate poorer health).

Table 5. Differences between measurement time points by GOLD grade.

	n	Week 4 – baseline Mean difference (95%CI)	Week 8 – week 4 Mean difference (95%CI)	Week 8 – baseline Mean difference (95%CI)
ESWT, seconds
GOLD II	22	218 (42, 395)*	63 (−52, 178)	281 (118, 444)*
GOLD III/IV	24	178 (35, 321)*	123 (−13, 258)	301 (133, 469)*
6MWD, metres
GOLD II	22	18 (1, 35)*	24 (4, 44)*	42 (23, 62)*
GOLD III/IV	25	25 (3, 48)*	−4 (−21, 13)	21 (1, 41)*
CAT
GOLD II	23	−2 (−3, −0.03)*	−1 (−3, 1)	−2 (−4, −0.2)*
GOLD III/IV	25	−1 (−3, 1)	−1 (−3, 1)	−2 (−4, 0)
HADS
Anxiety
GOLD II	23	−1 (−2, 1)	0 (−1, 2)	−1 (−3, 2)
GOLD III/IV	24	−1 (-2, −0.1)*	1 (0, 2)	0 (−2, 1)
Depression
GOLD II	23	0 (−1, 1)	0 (−2, 1)	0 (−2, 1)
GOLD III/IV	24	0 (−1, 1)	0 (−1, 1)	0 (−1, 1)
SGRQ
Symptoms
GOLD II	23	−4 (−13, 5)	−3 (−10, 4)	−7 (−15, 0)
GOLD III/IV	22	−9 (−16, −1)*	−5 (−12, 3)	−14 (−23, −4)*
Impact
GOLD II	23	−6 (−11, −1)*	0 (−6, 6)	−6 (−12, −1)*
GOLD III/IV	22	1 (−6, 7)	−3 (−6, 0)	−2 (−9, 5)
Activity
GOLD II	23	−6 (−12, 0)	1 (−6, 7)	−5 (−11, 1)
GOLD III/IV	22	−2 (−8, 5)	−1 (−5, 4)	−3 (−9, 4)
Total
GOLD II	23	−6 (-10, −2)*	0 (−5, 4)	−6 (−11, −2)*
GOLD III/IV	22	−2 (−7, 3)	−2 (−5, 0)	−4 (−10, 2)

Key: All data are represented as raw mean (SD). *p < 0.05; 6MWD, 6-minute walk distance; CAT, COPD Assessment Test (out of 40, higher scores indicate higher impact of COPD); ESWT, endurance shuttle walk test; HADS, Hospital Anxiety and Depression Scale (out of 21, higher scores indicate higher likelihood of depression and/or anxiety); m, metres; n, number; SGRQ, St. George’s Respiratory Questionnaire (out of 100, higher scores indicate poorer health).