Magnitude of exercise capacity and quality of life improvement following repeat pulmonary rehabilitation in patients with COPD
Bibliographic record
Abstract
Jacqueline S Sandoz,1,2 Mary M Roberts,1,3,4 Jin-Gun Cho,1,3–5 John R Wheatley1,3–5 1Respiratory Ambulatory Care Service, Western Sydney Local Health District, NSW, Australia; 2Canadian Alternatives in Non-invasive Ventilation (CANVent) Program, Ottawa Hospital Rehabilitation Centre, Division of Respiratory Medicine, Ottawa Hospital, Ontario, Canada; 3Department of Respiratory and Sleep Medicine, Westmead Hospital, 4Ludwig Engel Centre for Respiratory Research, Westmead Institute for Medical Research, 5Sydney Medical School, University of Sydney, Westmead, NSW, Australia Background: Maintenance and repeated pulmonary rehabilitation programs (PRPs) for patients with COPD have attempted to prolong PRP benefits beyond 12–24 months. However, there is limited evidence as to the magnitude of benefit or the ideal interval between repeating the program under “real-world” conditions in which patients are referred based on clinical necessity. Therefore, we reviewed the effects of repeating PRP in a physician-referred cohort of patients with COPD. Methods: A total of 141 individuals with COPD completed PRP twice and 35 completed PRP three times over a 12-year period. We used linear mixed-effects models to quantify the magnitude and change in 6-minute walk distance (6MWD), St George’s Respiratory Questionnaire (SGRQ), and Hospital Anxiety and Depression Scale (HADS) for each PRP. One-way analysis of variance with Tukey’s post hoc analysis compared the effects of different time intervals on 6MWD, SGRQ, and HADS between PRPs. Results: Despite 39 mL/year average decrease in forced expiratory volume in 1 second, overall 6MWD improved following each PRP (PRP1=58 m, P<0.0001; PRP2=42 m, P<0.0001; PRP3=32 m, P<0.003). Mean SGRQ decreased after PRP1 (-7.0 units; P<0.001) and PRP2 (-4.9 units;P<0.0001) but not after PRP3 (-3.2 units; P=0.10). HADS decreased after PRP1 (-1.9 units; P<0.0001) and PRP2 (-1.7 units; P=0.0001) but not after PRP3 (-0.4 units; P=0.63). Conclusion: In physician-referred patients who underwent repeat PRP as clinically required, there were clear benefits in functional exercise capacity following each repeat PRP, which was not affected by the time interval between PRPs. Health-related quality of life and mood improved after the first two PRPs, but not after a third. Keywords: exercise therapy, chronic obstructive pulmonary disease, quality of life, exercise test
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".