Effects of pharmacologic treatment based on airflow limitation and breathlessness on daily physical activity in patients with chronic obstructive pulmonary disease

Figures & data

Table 1 Criteria for selection of bronchodilator

GOLD stage	MMRC scale	Baseline treatment	Final treatment	No of patients
1 or 2	0–1	None	LAMA or LABA	5
1 or 2	2–4	None	LAMA + LABA	3
1 or 2	Any	LAMA or LABA	LAMA + LABA	6
3 or 4	0–1	None or LAMA or LABA	LAMA + LABA	3
3 or 4	2–4	None or LAMA or LABA	LAMA + ICS/LABA	4

Abbreviations: GOLD, Global Initiative for Chronic Obstructive Lung Disease; MMRC, Modified Medical Research Council; None, no bronchodilator; LAMA, long-acting muscarinic antagonist; LABA, long-acting beta-2 adrenergic agonist; ICS, inhaled corticosteroid.

Table 2 Characteristics of patients

Sex (M/F)	21/0
Age (years)	70.7±7.7
BMI (kg/m^2)	21.3±3.3
Smoking
Cur/Ex/Non	6/15/0
Pack-year	63.7±31.1
MMRC scale (0/1/2/3/4)	7/7/5/2/0
Staging (I/II/III/IV)	4/10/4/3
Pulmonary function
FVC (L)	3.50±0.65
FEV1 (L)	1.72±0.63
FEV1 % (%)	48.2±13.3
FEV1 % predicted (%)	59.8±21.7
IC (L)	2.13±0.37
IC/TLC (%)	33.3±6.4
FRC (L)	4.32±0.81
RV (L)	2.84±0.62
TLC (L)	6.47±0.85
DLCO (mL/min/mmHg)	14.87±5.16
DLCO/VA (mL/min/mmHg/L)	3.24±1.15

Abbreviations: BMI, body mass index; Cur, current smoker; Ex, ex smoker; Non, nonsmoker; MMRC, Modified Medical Research Council; FVC, forced vital capacity; FEV₁, forced expiratory volume in 1 second; FEV_l%, 100 × FEV_l/FVC; FEV_l% predicted, 100 × FEV_l/predicted FEV_l; IC, inspiratory capacity; TLC, total lung capacity; FRC, functional residual capacity; RV, residual volume; DLCO, pulmonary carbon monoxide diffusing capacity; min, minute; VA, alveolar volume.

Table 3 Effects of medication on pulmonary function tests and ISWT

Variables	Pre	Post	P-value
VC (L)	3.58±0.65	3.76±0.63	0.007
IC (L)	2.13±0.37	2.27±0.35	0.001
FVC (L)	3.50±0.65	3.63±0.55	0.008
FEV1 (L)	1.72±0.63	1.86±0.58	0.001
FRC (L)	4.32±0.81	4.24±0.85	0.249
RV (L)	2.84±0.62	2.67±0.61	0.015
TLC (L)	6.47±0.85	6.46±0.97	0.936
DLCO (mL/min/mmHg)	14.87±5.16	14.61±5.15	0.293
DLCO/VA (mL/min/mmHg/L)	3.24±1.15	3.20±1.15	0.438
ISWT (m)	464.7±118.0	499.4±108.7	0.033

Abbreviations: ISWT, incremental shuttle walking test; VC, vital capacity; IC, inspiratory capacity; FVC, forced vital capacity; FEV₁, forced expiratory volume in 1 second; FRC, functional residual capacity; RV, residual volume; TLC, total lung capacity; DLCO, pulmonary carbon monoxide diffusing capacity; VA, alveolar volume; min, minute.

Figure 1 Effect of medication on the PA level.

Abbreviations: PA, physical activity; METs·hr, metabolic equivalents multiplied by hours.

Figure 2 Effects of medication on the duration of PA.

Abbreviations: PA, physical activity; METs, metabolic equivalents; min, minutes.

Figure 3 The degree of improvement in PA according to the intensity.

Notes: Horizontal lines indicate mean ± SD. P=0.193 with one-way analysis of variance.
Abbreviations: PA, physical activity; SD, standard deviation; METs, metabolic equivalents.

Table 4 Correlation coefficients between % change in PA and baseline pulmonary function tests or ISWT

Variables	≥2.0 METs	≥2.5 METs	≥3.0 METs	≥3.5 METs	≥3.0 METs⋅hr
VC	0.094	0.326	0.418	0.237	0.352
FVC	0.094	0.334	0.473a	0.228	0.407
FEV1	0.405	0.387	0.427	0.104	0.365
FRC	−0.247	0.068	0.008	−0.537a	−0.052
RV	−0.396	−0.179	−0.384	−0.543a	−0.425
TLC	−0.271	0.086	−0.085	−0.298	−0.162
IC/TLC	0.326	0.216	0.395	0.518a	0.442
DLCO	0.381	0.147	0.352	0.262	0.382
ISWT	0.060	0.265	0.335	−0.065	0.233

Note:

a P<0.05.

Abbreviations: PA, physical activity; ISWT, incremental shuttle walking test; METs, metabolic equivalents; METs·hr, METs multiplied by hours; VC, vital capacity; FVC, forced vital capacity; FEV₁, forced expiratory volume in 1 second; FRC, functional residual capacity; RV, residual volume; IC, inspiratory capacity; TLC, total lung capacity; DLCO, pulmonary carbon monoxide diffusing capacity.

Table 5 Correlation coefficients between % change in PA and % change in pulmonary function tests or ISWT

Variables	≥2.0 METs	≥2.5 METs	≥3.0 METs	≥3.5 METs	≥3.0 METs⋅hr
VC	−0.170	−0.102	−0.020	0.277	−0.003
IC	−0.130	0.118	0.071	−0.031	0.081
FVC	0.072	0.079	0.114	0.153	0.166
FEV1	−0.116	0.117	0.283	0.302	0.319
FRC	−0.296	−0.468a	−0.374	0.065	−0.375
RV	0.062	−0.130	−0.209	0.059	−0.235
TLC	−0.238	−0.300	−0.304	0.101	−0.316
DLCO	−0.186	−0.309	−0.250	−0.298	−0.201
ISWT	−0.332	−0.401	−0.123	0.439	−0.059

Note:

a P<0.05.

Abbreviations: PA, physical activity; ISWT, incremental shuttle walking test; METs, metabolic equivalents; METs·hr, METs multiplied by hours; VC, vital capacity; IC, inspiratory capacity; FVC, forced vital capacity; FEV₁, forced expiratory volume in 1 second; FRC, functional residual capacity; RV, residual volume; TLC, total lung capacity; DLCO, pulmonary carbon monoxide diffusing capacity.