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People With COPD Who Respond to Ground-Based Walking Training Are Characterized by Lower Pre-training Exercise
Jian Ping Ho1, Jennifer A Alison, L W Cindy Ng
1School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Western Australia, Australia (Ms Ho and Drs Jenkins, Eastwood, Cavalheri, and Hill); Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Lidcombe, New South Wales, Australia (Drs Alison, Wootton, and McKeough); Sydney Local Health District, New South Wales, Australia (Drs Alison and Spencer); Physiotherapy Department, Singapore General Hospital, Singapore (Dr Ng); Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, New South Wales, Australia (Dr Wootton); Institute for Respiratory Health (Drs Jenkins, Eastwood, Cavalheri, and Hill), Physiotherapy Department (Dr Jenkins), and Department of Pulmonary Physiology & Sleep Medicine (Drs Eastwood and Hillman), Sir Charles Gairdner Hospital, Western Australia, Australia; Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Western Australia, Australia (Dr Eastwood); and Department of Thoracic Medicine, Concord Hospital, Concord, New South Wales, Australia (Dr Jenkins).
Purpose:
To investigate the characteristics that distinguish responders from nonresponders to ground-based walking training (GBWT) in people with chronic obstructive pulmonary disease (COPD).
Methods:
An analysis was undertaken of data collected during a trial of GBWT in people with COPD. Responders to GBWT were defined in 2 ways: (1) improved time on the endurance shuttle walk test of ≥190 sec (criterion A); or (2) improved ability to walk, perceived by the participant to be at least "moderate" (criterion B). Differences in participant characteristics, pre-training exercise capacity, health-related quality of life, and the improvement in the distance walked during the training program were examined between responders and nonresponders.
Results:
Of the 95 participants randomized to GBWT (age 69 ± 8 yr, forced expiratory volume in 1 sec [FEV1] % predicted = 43% ± 15%), data were available for analysis on 78 and 73 patients by criterion A and criterion B, respectively. According to criterion A, 32 (41%) participants were responders. The odds of being a responder increased with increasing FEV1 % predicted (OR = 1.2; 95% CI, 1.0-1.5, for every 5% increase) and increased with decreasing pre-training incremental shuttle walk distance (OR = 1.4; 95% CI, 1.0-1.8, for every 50-m decrement). According to criterion B, 42 (58%) participants were responders. There were no differences in characteristics or pre-training measures between the responders and nonresponders. For both criteria, responders demonstrated greater change in the distance walked during the training program (P < .05).
Conclusion:
Responders to GBWT had lower pre-training exercise capacity, had better lung function, and demonstrated greater change in the distance walked during the training program.
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