Figures
- FIGURE 1
CONSORT recruitment diagram for enrolment and study completion. BMI: body mass index; ISWT: incremental shuttle walk test; FCP: Fortisip Compact Protein.
- FIGURE 2
Post-pulmonary rehabilitation incremental shuttle walk test (ISWT) distance in the control (305±148 m) and intervention groups (342±149 m) (p=0.10). Data are presented as mean and standard deviation.
Tables
- TABLE 1
Demographic data and baseline characteristics of the chronic obstructive pulmonary disease (COPD) patients who completed the study
Control Intervention p-value# Subjects 22 22 Demographics Age years 70±9 75±6 0.04* Sex 0.53 Male 13 (59) 15 (68) Female 9 (41) 7 (32) Active smoker 10 (45) 5 (23) 0.20 Ex-smoker 12 (55) 17 (77) Smoking history pack-years 39 (24–59) 45 (28–93) 0.41 Exacerbation within last year 1 (0–2) 0 (0–1) 0.21 Hospitalisation due to exacerbations within last year 0 (0–1) 0 (0–0) 0.03* Medications SABA 15 (68) 15 (68) 0.81 LABA 15 (68) 9 (41) 0.09 SAMA 0 0 LAMA 16 (73) 8 (36) 0.02* ICS 12 (54) 7 (32) 0.16 Nonrespiratory medications 17 (77) 20 (91) 0.09 Diabetes 0 0 Pulmonary function FEV1 L 1.2 (1–2) 1.6 (1–2) 0.27 FEV1 % pred 52±19 59±22 0.18 FEV1/FVC % 54±12 53±13 0.90 Anthropometric measurements Weight kg 68±13 75±16 0.12 Waist circumference cm 92±14 96±15 0.46 Hip circumference cm 98±9 104±11 0.04* Mid-thigh circumference cm 56±8 59±6 0.16 Body composition Fat mass kg 24±7 26±6 0.50 BMI kg·m−2 23±4 24±4 0.36 Fat-free mass kg 43±10 49±13 0.12 FFMI kg·m−2 15±3 16±3 0.17 Functional outcomes ISWT m 265±133 269±130 0.92 mMRC grade 3 (2–3) 3 (2–3) 0.87 Right handgrip kg 26±19 30±10 0.15 Left handgrip kg 25±9 29±9 0.16 STS5 s 11 (7–13) 10 (9–12) 0.94 Questionnaires CAT score 20±8 18±6 0.37 Anxiety (HADS) score 6 (4–9) 4 (3–10) 0.42 Depression (HADS) score 6±3 5±3 0.19 SGRQ total score 52±17 41±13 0.02* SGRQ symptoms score 63±23 52±21 0.14 SGRQ activity score 57 (57–86) 57 (53–69) 0.03* SGRQ impact score 38±19 27±12 0.03* MUST score 0 (0–1) 0 (0–0) 0.50 Physical activity steps·day−1 2663 (1947–4912) 4297 (1726–7211) 0.33 Data are presented as n, mean±sd, n (%) or median (interquartile range), unless otherwise stated. SABA: short-acting β-agonist; LABA: long-acting β-agonist; SAMA: short-acting muscarinic antagonist; LAMA: long-acting muscarinic antagonist; ICS: inhaled corticosteroid; FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; BMI: body mass index; FFMI: fat-free mass index; ISWT: incremental shuttle walk test; mMRC: modified Medical Research Council; STS5: five-repetition sit-to-stand test; CAT: COPD Assessment Test; HADS: Hospital Anxiety and Depression Scale; SGRQ: St George's Respiratory Questionnaire; MUST: Malnutrition Universal Screening Tool. #: p-values were calculated using the Chi-squared, paired t-test for normally distributed data and the Wilcoxon signed-rank test for nonnormally distributed data, and represent a comparison between the control and intervention groups. *: p<0.05.
- TABLE 2
Within- and between-group changes in functional outcomes, anthropometric measurements, body composition, health-related quality of life and physical activity following pulmonary rehabilitation#
Control Intervention Between-group difference¶ 95% CI Effect size p-value+ Pre Post Pre Post Functional outcomes ISWT m 265±133 305±148 269±129 342±149 32±85 −5–70 2.7 0.10 mMRC grade 3 (2–3) 3 (2–3) 3 (2–3) 3 (2–3) 0 (0–0) 0 1 Right handgrip kg 26±19 29±9 30±10 32±10 0.5±5 −2–3 1.5 0.44 Left handgrip kg 25±9 28±10 29±9 30±10 0.9±7 −2–4 0.5 0.33 STS5 s 10 (7–13) 8 (6–10) 11 (9–12) 9 (7–12) −1 (−4–0.3) −5–0.2 4 0.08 Anthropometric measurements Weight kg 68±13 69±13 75±16 76±16 0.4±2 −0.6–2 0.2 0.50 Waist circumference cm 94 (78–105) 94 (77–102) 93 (87–105) 96 (85–111) 1 (−3–1) 1–3 0.1 0.38 Hip circumference cm 98±9 98±9 104±11 103±9 2±6 −1–4 1.2 0.11 Mid-thigh circumference cm 56±8 58±6 59±6 61±5 0.4±6 −2–3 0.05 0.75 Body composition Fat mass kg 26 (18–30) 25 (18–30) 27 (21–32) 27 (19–33) 2 (−2–4) −3–4 0.03 0.24 Fat-free mass kg 41 (34–52) 42 (34–56) 52 (37–61) 49 (38–59) 0.3 (−3–4) −2–5 0.3 0.88 FFMI kg·m−2 15±3 15±3 16±3 17±4 0.1±2 −1–1 0.001 0.38 Questionnaires CAT score 20±8 19±8 18±6 17±7 0.04±8 −3–3 0.12 0.98 Anxiety (HADS) score 7±4 6±5 6±5 5±5 0.4±3 −1–2 1 0.55 Depression (HADS) score 6±3 6±3 5±3 4±4 0.5±3 −1–2 0.03 0.39 SGRQ total score 52±17 51±17 41±13 43±16 2±15 −5–10 0.006 0.48 SGRQ symptoms score 63±23 57±20 52±21 49±27 3±28 −11–17 0.06 0.76 SGRQ activity score 72±18 71±19 60±17 66±21 6±21 −5–16 0.5 0.20 SGRQ impact score 38±19 36.6±20 27±12 28±16 0.5±18 −9–10 0.001 0.74 MUST score 0 (0–1) 0 (0–1) 0 (0–0) 0 (0–0) 0 (0–0) 0 1 Physical activity steps·day−1 2663 (1947–4912) 2903 (1800–4753) 4297 (1726–7211) 5973 (2000–6812) 31
(−1421–1337)−974–1369 0.04 0.88 Data are presented as mean±sd or median (interquartile range), unless otherwise stated. ISWT: incremental shuttle walk test; mMRC: modified Medical Research Council; STS5: five-repetition sit-to-stand test; FFMI: fat-free mass index; CAT: COPD Assessment Test; COPD: chronic obstructive pulmonary disease; HADS: Hospital Anxiety and Depression Scale; SGRQ: St George's Respiratory Questionnaire; MUST: Malnutrition Universal Screening Tool. #: control n=22 and intervention n=22; ¶: mean difference for each group was calculated by subtracting baseline from post-rehabilitation measurements; +: p-values were calculated using the paired t-test for normally distributed data and the Wilcoxon signed-rank test for nonnormally distributed data, and represent the change between the mean differences in the control and intervention groups.
- TABLE 3
Baseline characteristics between responders and nonresponders to the incremental shuttle walk test (ISWT) in the intervention group
Responders Nonresponders p-value Subjects 13 9 Demographics Age years 74±5 78±6 0.15 Sex 0.90 Male 9 (69) 6 (66) Female 4 (31) 3 (33) Ex-smoker 10 (77) 7 (78) 0.96 Smoking history pack-years 49 (28–105) 45 (21–49) 0.34 Exacerbation within last year 5 (38) 5 (56) 0.43 Hospitalisation due to exacerbations within last year 0 (0) 1 (11) 0.22 Anthropometric measurements Weight kg 78±14 71±18 0.32 Waist circumference cm 98±12 92±18 0.33 Hip circumference cm 106±8 102±15 0.44 Mid-thigh circumference cm 62±4 55±6 0.006* Pulmonary function FEV1 % pred 59±22 52±19 0.28 FEV1/FVC % 53±13 54±12 0.75 Body composition BMI kg·m−2 25±3 24±5 0.50 Fat-free mass kg 16±2 15±3 0.29 FFMI kg·m−2 52±13 45±14 0.38 Functional outcomes ISWT m 265±134 274±132 0.88 mMRC grade 3 (2–3) 3 (2–3) 0.95 Right handgrip kg 32±12 28±8 0.45 Left handgrip kg 30±10 27±8 0.43 STS5 s 11±3 11±4 0.89 Questionnaires CAT score 19±6 18±7 0.78 Anxiety (HADS) score 6 (2–13) 3 (2–7) 0.26 Depression (HADS) score 7±4 3±2 0.04* SGRQ total score 42±14 39±12 0.56 MUST score 0 (0–0) 0 (0–2) 0.36 Physical activity steps·day−1 4909±2851 3930±3495 0.49 Data are presented as n, mean±sd, n (%) or median (interquartile range), unless otherwise stated. FEV1: forced expiratory volume in 1 s; FVC: forced vital capacity; BMI: body mass index; FFMI: fat-free mass index; mMRC: modified Medical Research Council dyspnoea scale; STS5: five-repetition sit-to-stand test; CAT: COPD Assessment Test; COPD: chronic obstructive pulmonary disease; HADS: Hospital Anxiety and Depression Scale; SGRQ: St George's Respiratory Questionnaire; MUST: Malnutrition Universal Screening Tool. *: p<0.05.
Supplementary Material
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Supplementary material 00077-2021.supplement
