PMID- 31920298
OWN - NLM
STAT- MEDLINE
DCOM- 20200709
LR  - 20200709
IS  - 1178-2005 (Electronic)
IS  - 1176-9106 (Print)
IS  - 1176-9106 (Linking)
VI  - 14
DP  - 2019
TI  - Baseline Exercise Tolerance and Perceived Dyspnea to Identify the Ideal Candidate 
      to Pulmonary Rehabilitation: A Risk Chart in COPD Patients.
PG  - 3017-3023
LID - 10.2147/COPD.S223038 [doi]
AB  - BACKGROUND: The appropriate criteria for patient selection are still a key issue 
      in the clinical management of patients referred to pulmonary rehabilitation (PR). 
      METHODS: We retrospectively analyzed the records of a wide population of 1470 
      outpatient or inpatients with chronic obstructive pulmonary disease (COPD) 
      referred to standard PR at two specialized Italian centers. Two models of 
      multivariate logistic regression were developed to test the predictive powers of 
      baseline exercise tolerance, namely the distance walked in 6 mins (6MWD), and of 
      baseline dyspnea on exertion, measured by the modified Medical Research Council 
      scale (mMRC), versus the minimal clinically important difference (MCID) for the 
      same outcomes. RESULTS: Compared to the category of individuals with 6MWD >350 
      meters, those patients with 201-350 meters and </=200 meters showed a higher 
      probability (p<0.001) of predicting a MCID change. Compared to the category of 
      individuals with mMRC 0-1point, all the other categories (2, 3, and 4) also 
      showed a higher probability (p<0.001) of predicting a MCID change. The 
      incorporation of baseline categories of 6MWD and mMRC in a risk chart showed that 
      the percentage of patients reaching MCID in both variables increased as the 
      baseline level of 6MWD decreased and of mMRC increased. CONCLUSION: This study 
      demonstrates that lower levels of exercise tolerance and greater perceived 
      dyspnea on exertion predict achieving clinically meaningful changes for both 
      these treatment outcomes following PR. A specific risk chart that integrates 
      these two variables may help clinicians to select ideal candidates and best 
      responders to PR.
CI  - (c) 2019 Costi et al.
FAU - Costi, Stefania
AU  - Costi S
AUID- ORCID: 0000-0002-4645-0336
AD  - Department of Surgical, Medical and Dental Department of Morphological Sciences 
      Related to Transplants Oncology and Regenerative Medicine-University of Modena 
      and Reggio Emilia and Azienda Unita Sanitaria Locale - IRCCS, Reggio Emilia, 
      Italy.
FAU - Crisafulli, Ernesto
AU  - Crisafulli E
AUID- ORCID: 0000-0001-7298-7084
AD  - Department of Medicine, Respiratory Medicine Unit and Section of Internal 
      Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata of 
      Verona, Verona, Italy.
FAU - Trianni, Ludovico
AU  - Trianni L
AD  - Rehabilitation Unit-Hospital Villa Pineta, Pavullo Nel Frignano, Modena, Italy.
FAU - Beghe, Bianca
AU  - Beghe B
AD  - Department of Medical and Surgical Sciences-University of Modena and Reggio 
      Emilia and University Hospital of Modena Policlinico, Modena, Italy.
FAU - Faverzani, Silvia
AU  - Faverzani S
AUID- ORCID: 0000-0001-7989-4956
AD  - Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, 
      University of Parma, Parma, Italy.
FAU - Scopelliti, Giuseppe
AU  - Scopelliti G
AUID- ORCID: 0000-0002-7393-3931
AD  - Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, 
      University of Parma, Parma, Italy.
FAU - Chetta, Alfredo
AU  - Chetta A
AD  - Department of Medicine and Surgery, Respiratory Disease and Lung Function Unit, 
      University of Parma, Parma, Italy.
FAU - Clini, Enrico
AU  - Clini E
AUID- ORCID: 0000-0002-1515-5094
AD  - Department of Medical and Surgical Sciences-University of Modena and Reggio 
      Emilia and University Hospital of Modena Policlinico, Modena, Italy.
LA  - eng
PT  - Journal Article
DEP - 20191227
PL  - New Zealand
TA  - Int J Chron Obstruct Pulmon Dis
JT  - International journal of chronic obstructive pulmonary disease
JID - 101273481
SB  - IM
MH  - *Dyspnea/diagnosis/psychology
MH  - *Exercise Therapy/methods/psychology
MH  - *Exercise Tolerance
MH  - Female
MH  - Humans
MH  - Italy
MH  - Male
MH  - Middle Aged
MH  - Minimal Clinically Important Difference
MH  - *Patient Selection
MH  - Predictive Value of Tests
MH  - Pulmonary Disease, Chronic Obstructive/diagnosis/physiopathology/*rehabilitation
MH  - Risk Assessment/methods
MH  - *Walk Test/methods/standards
PMC - PMC6938185
OTO - NOTNLM
OT  - chronic obstructive pulmonary disease
OT  - dyspnea
OT  - exercise tolerance
OT  - minimal clinically important difference
OT  - patient selection
OT  - pulmonary rehabilitation
COIS- The authors declare that there is no conflict of interest regarding the 
      publication of this paper.
EDAT- 2020/01/11 06:00
MHDA- 2020/07/10 06:00
PMCR- 2019/12/27
CRDT- 2020/01/11 06:00
PHST- 2019/07/12 00:00 [received]
PHST- 2019/11/21 00:00 [accepted]
PHST- 2020/01/11 06:00 [entrez]
PHST- 2020/01/11 06:00 [pubmed]
PHST- 2020/07/10 06:00 [medline]
PHST- 2019/12/27 00:00 [pmc-release]
AID - 223038 [pii]
AID - 10.2147/COPD.S223038 [doi]
PST - epublish
SO  - Int J Chron Obstruct Pulmon Dis. 2019 Dec 27;14:3017-3023. doi: 
      10.2147/COPD.S223038. eCollection 2019.