Abstract
We aimed contrast the effects of exercise training in COPD patients with and without reductions in fat-free mass (FFM) and evaluate the relationship among changes in body composition, exercise capacity and health related quality of life.
One hundred and four patients submitted to Pulmonary Rehabilitation (PR) were retrospectively stratified according their FFM status. FFM was measured by bioelectrical impedance and patients considered depleted if FFM index was ≤ 15 in women and ≤ 16 kg/m2 in men). Saint George Respiratory Questionnaire (SGRQ) and 6 minute walk distance (6MWD) were evaluated before and after PR.
Characteristics of all patients are following: 64.1±8.7 years; body mass index (BMI)= 25.1±4.7 Kg/m2; FFM index= 17.1±3.0 Kg/m2; FVC=66.4±20.1%; FEV1= 38.9±15.2%; 6MWD= 395.3±85.5m; and oxygen saturation (SpO2)=93.2±4.2%. Thirty two subjects (30.7%) were considered depleted. They had worse resting lung function and SpO2 (CVF= 59.4±19.5 vs 69.6 vs 19.6%, p=0.02; FEV1=33.6±13.2 vs 41.4±15.5%, p=0.02; SpO2= 91.7±4.8 vs 93.9±3.8, p=0.02). Improvement in 6MWD and SGRQ after PR were not different comparing groups. There is no difference in weight alteration (0.14±3.3 vs -0.43±2.7 Kg) whereas depleted patients had a greater improvement in fat free mass (3.71±7.89 vs -0.29±2.56Kg; p<0.01). Therefore, 24 of 32 depleted subjects (75%) were no more considered depleted after PR. This improvement has no correlation with SGRQ and 6MWD gains after PR.
Concluding, the clinical benefits of PR were not different comparing FFM depleted and non-depleted COPD patients. However, improvement in FFM was greater in depleted patients leading the majority of them to be considered non-depleted after PR.
- © 2012 ERS