Metabolic disease and participant age are independent predictors of response to pulmonary rehabilitation

J Cardiopulm Rehabil Prev. Jul-Aug 2013;33(4):249-56. doi: 10.1097/HCR.0b013e31829501b7.


Purpose: The study aims were (1) to determine whether baseline measures-including the Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) index; Age, Dyspnea, and Airflow Obstruction (ADO) index; physical activity; comorbidities (cardiac, metabolic, or musculoskeletal disease); and the number of hospitalizations over the previous 12 months-can predict responders in 6-minute walk distance (6MWD) following pulmonary rehabilitation (PR) and (2) to determine whether different methods in defining improvement in 6MWD affected identifying responders to PR.

Methods: All participants with chronic obstructive pulmonary disease who attended PR at our institution between 2004 and 2009 were evaluated. A participant was classified as a responder with improvement in 6MWD (≥25 m or ≥2 SD of this dataset coefficient of repeatability).

Results: A total of 203 participants (mean age, 68.2 ± 8.7 years; mean predicted forced expiratory volume in 1 second, 52.5 ± 22.4%) were analyzed. One hundred twenty participants (59.1%) had a comorbidity categorized as cardiac, metabolic, or musculoskeletal disease. The binary logistic regression models showed that younger participants (P ≤ .015) and, when using the coefficient of repeatability method (≥60.9 m), participants with metabolic disease (P = .040) were the only independent predictors of response. No other measure, including participant BODE or ADO index scores, contributed to either model.

Conclusion: Identifying responders in exercise capacity following PR remains difficult, with only age and participants with metabolic disease identified as independent predictors.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Body Mass Index
  • Exercise Therapy / methods*
  • Exercise Tolerance / physiology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / etiology*
  • Motor Activity / physiology*
  • Prevalence
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Queensland / epidemiology
  • Retrospective Studies
  • Risk Factors