科研之友
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摘要
objective: to identify factors associated with the minimal clinically important difference (mcid) for health-related quality of life (hrqol) after physical conditioning in patients with copd. methods: thirty-five patients were submitted to a 12-week program of physical conditioning (strength training plus low-intensity aerobic exercise). body composition, incremental treadmill test results, endurance treadmill test results, six-minute walk test results, peripheral muscle strength, mip, baseline dyspnea index (bdi) and saint george%26apos;s respiratory questionnaire (sgrq) scores were assessed at baseline and after the program, thus allowing the variations (汛) to be calculated. the mcid for hrqol was defined as a reduction of %26gt; 4% in the sgrq total score. subjects who responded to the program, achieving the mcid for hrqol, were allocated to the responders (r) group (n = 24), and the remainder were allocated to the non-responders (nr) group (n = 11). results: the values obtained for the following variables were significantly higher in group r than in group nr (p %26lt; 0.05): fev1 (1.48 ㊣ 0.54 l vs. 1.04 ㊣ 0.34 l); vef1/fvc (47.9 ㊣ 11.7% vs. 35.5 ㊣ 10.7%); pao2 (74.1 ㊣ 9.7 mmhg vs. 65.0 ㊣ 8.9 mmhg); and 汛bdi, expressed as median and interquartile range (2.0 [0.0-3.5] vs. 0.0 [0.0-1.0]). the 汛bdi correlated significantly with the 汛sgrq symptoms domain score, activity domain score and total score (r = 0.44, 0.60 and 0.62, respectively, p %26lt; 0.01 for all). after logistic regression, only 汛bdi remained as a predictor of mcid for hrqol. conclusions: achieving the mcid for hrqol after physical conditioning is associated with dyspnea reduction in copd patients. therefore, there is a need to develop treatment strategies designed to interrupt the dyspnea-inactivity-dyspnea cycle in such patients.
