Journal Article

Association between patient-reported outcomes and exercise test outcomes in patients with COPD before and after pulmonary rehabilitation

Meys, Roy, Burtin, Chris, Wouters, Emiel F. M., Houben-Wilke, Sarah, Janssen, Daisy J. A., Spruit, Martijn A., Stoffels, Anouk A. F., van Hees, Hieronymus W. H., Franssen, Frits M. E., van den Borst, Bram

2020

Overview

Background Over the years, the scope of outcomes assessment in chronic obstructive pulmonary disease (COPD) has broadened, allowing for the evaluation of various patient-reported outcomes (PROs). As it still remains unclear whether and to what extent PROs mirror the exercise performance of patients with COPD, the current study aimed to assess the association between different exercise test outcomes and PROs, before and after pulmonary rehabilitation (PR). Methods Correlations between PROs used to describe health-related quality of life (HRQoL), mood status, level of care dependency and dyspnea in patients with COPD and commonly used laboratory- and field-based exercise test outcomes were evaluated in 518 individuals with COPD attending PR. Results Overall, correlations between PROs and exercise test outcomes at baseline were statistically significant. The correlation between modified Medical Research Council (mMRC) dyspnea score and 6-min walking distance (6MWD) was strongest (ρ:-0.65; p <0.001). HRQoL related PROs showed weak correlations with exercise outcomes at baseline. Moderate correlations were found between St George’s Respiratory Questionnaire total score and 6MWD ( r :-0.53; p <0.001) and maximal workload achieved during cardiopulmonary exercise testing ( ρ :-0.48; p <0.001); and between Clinical COPD Questionnaire (CCQ) total score and 6MWD ( r :-0.48; p <0.001) and maximal workload ( ρ :-0.43; p <0.001). When significant, correlations between changes in exercise test outcomes and changes in PROs after PR were generally very weak or weak. The highest correlation was found between changes in CCQ total score and changes in 6MWD (ρ: − 0.36; p <0.001). Conclusions PROs and exercise test outcomes, although significantly correlated with each other, assess different disease features in patients with COPD. Individual PROs need to be supported by additional functional measurements whenever possible, in order to get a more detailed insight in the effectiveness of a PR program. Trial registration Netherlands Trial Register ( NL3263 /NTR3416). Registered 2 May 2012.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Anxiety / Care and treatment / Chronic obstructive lung disease / Chronic obstructive pulmonary disease / Clinical outcomes / COPD / Dyspnea / Emotions / Endurance / Exercise / Exercise test / Exercise tests / Lung diseases / Medical research / Medicine / Medicine & Public Health / Obstructive lung disease / Patient outcomes / Patient-reported outcome measures / Patients / Pulmonary rehabilitation / Quality of life / Quality of Life Research / Questionnaires / Rehabilitation / Respiration / Statistical analysis / Walking / Workload / Workloads