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Smallest worthwhile effect of land-based and water-based pulmonary rehabilitation for COPD

Renae J. McNamara, Mark R. Elkins, Manuela L. Ferreira, Lissa M. Spencer, Robert D. Herbert
ERJ Open Research 2015 1: 00007-2015; DOI: 10.1183/23120541.00007-2015
Renae J. McNamara
1Prince of Wales Hospital, Randwick, Australia
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  • For correspondence: renae.mcnamara@sesiahs.health.nsw.gov.au
Mark R. Elkins
2The University of Sydney, Sydney, Australia
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Manuela L. Ferreira
3George Institute for Global Health, Camperdown, Australia
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Lissa M. Spencer
4Royal Prince Alfred Hospital, Camperdown, Australia
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Robert D. Herbert
5Neuroscience Research Australia (NeuRA), Randwick, Australia
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  • FIGURE 1
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    FIGURE 1

    Distribution of the smallest worthwhile effects (SWEs) of land-based pulmonary rehabilitation on 6-min walk distance (in metres) nominated by people with chronic obstructive pulmonary disease (n=100).

  • FIGURE 2
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    FIGURE 2

    Distribution of the smallest worthwhile effects (SWEs) of water-based pulmonary rehabilitation on 6-min walk distance (in metres) nominated by people with chronic obstructive pulmonary (n=98). Two outlying values (564 and 744 m) are not shown.

  • FIGURE 3
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    FIGURE 3

    Distribution of the differences in smallest worthwhile effects (SWEs) of land-based and water-based pulmonary rehabilitation on 6-min walk distance (in metres) nominated by people with chronic obstructive pulmonary disease. Difference values are water-based SWE minus land-based SWE, so a value to the right of zero indicates that the participant required a greater improvement from pulmonary rehabilitation when the exercise component was water-based to feel that the benefit would outweigh the cost, risk and inconvenience (n=98). Two outlying values (525 and 584 m) are not shown.

Tables

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  • TABLE 1

    Baseline characteristics of study participants

    CharacteristicParticipants
    Participants100
    Age years72±9
    Males/females43/57
    BMI kg·m−227 (6)
    Pulmonary function
     FEV1 L1.34±0.51
     FEV1 % predicted54±16
     FVC L2.50±0.77
     FVC % predicted77±19
     FEV1/FVC %54±11
    6MWD m377±101
    GOLD stage n
     I2
     II60
     III28
     IV10
    SGRQ score#,¶
     Total45±17
     Symptoms56±20
     Activity65±20
     Impact31±19
    • Data are presented as n or mean±sd. All values are post-bronchodilator. BMI: body mass index; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; 6MWD: 6-min walk distance; GOLD: Global Initiative for Chronic Obstructive Lung Disease; SGRQ: St George's Respiratory Questionnaire. #: on a scale from 0 to 100; ¶: 12 missing data points.

  • TABLE 2

    Estimates of smallest worthwhile effects of pulmonary rehabilitation in people with chronic obstructive pulmonary disease

    PercentileSmallest worthwhile effect on 6MWD m
    Land-basedWater-based
    80%64 (50–80)72 (51–100)
    50%20 (15–37)26 (15–33)
    20%4 (3–6)4 (4–7)
    • Data are presented as mean (95% CI). 6MWD: 6-min walk distance.

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Smallest worthwhile effect of land-based and water-based pulmonary rehabilitation for COPD
Renae J. McNamara, Mark R. Elkins, Manuela L. Ferreira, Lissa M. Spencer, Robert D. Herbert
ERJ Open Research May 2015, 1 (1) 00007-2015; DOI: 10.1183/23120541.00007-2015

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Smallest worthwhile effect of land-based and water-based pulmonary rehabilitation for COPD
Renae J. McNamara, Mark R. Elkins, Manuela L. Ferreira, Lissa M. Spencer, Robert D. Herbert
ERJ Open Research May 2015, 1 (1) 00007-2015; DOI: 10.1183/23120541.00007-2015
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