Stability and Predictors of Poor 6-min Walking Test Performance over 2 Years in Patients with COPD
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Participants
2.2. Measurements
2.3. Outcome Measure
2.4. Predictor Variables
2.5. Statistical Analysis
3. Results
3.1. Participants
3.2. Stability and Predictors of Poor 6MWT Performance over a 2-Year Period
3.3. Temporal Evolution of Relevant Non-Pulmonary Predictors over 2 Years
4. Discussion
4.1. Implications for Practice and Research
4.2. Strengths and Limitations of the Study
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Characteristics | All (n = 137) | <350 m (n = 55) | ≥350 m (n = 82) | p-Value |
---|---|---|---|---|
Sociodemographic variables | ||||
Age (years), mean ± SD | 66.9 ± 8.3 | 69.97.8 | 64.8 ± 8.0 | 0.000 * |
Male | 120(87.6) | 51(92.7) | 69(84.1) | 0.135 |
Clinical and Pulmonary variables | ||||
BMI (kg/m2), mean ± SD | 28.9 ± 5.0 | 28.6 ± 5.4 | 29.0 ± 4.8 | 0.645 |
Smoking, mean pack-years ±SD | 58.7 ± 25.5 | 66.7 ± 26.1 | 53.4 ± 23.7 | 0.002 * |
Current smoker | 10(29.9) | 14(25.5) | 27(32.9) | 0.349 |
Number Comorbidities, mean ± SD | 3.1 ± 1.6 | 3.1 ± 1.6) | 3.1 ± 1.7 | 0.831 |
Heart disease (yes) | 19(13.9) | 10(18.2) | 9(11.0) | 0.232 |
Dyspnea (mMRC ≥ 2) | 49(35.2) | 29(52.7) | 20(24.4) | 0.001 * |
Number of Exacerbations b, mean ± SD | 1.4 ± 1.4) | 2.3 ± 1.9 | 1.7 ± 1.4 | 0.034 * |
CAT ≥ 10 | 100(73.0) | 43(78.2) | 57(69.5) | 0.263 |
FEV1 (litres), mean ± SD | 1.3 ± 0.4 | 1.1 ± 0.4 | 1.4 ± 0.4 | 0.001 * |
FEV1 (% predicted), mean ± SD | 50.2 ± 16.5 | 46.0 ± 16.5 | 53.0 ± 16.0 | 0.014 * |
FVC (litres), mean ± SD | 2.2 ± 0.6 | 1.9 ± 0.5 | 2.3 ± 0.7 | 0.001 * |
FVC (% predicted), mean ± SD | 66.6 ± 18.7 | 61.5 ± 17.3 | 70.1 ± 18.9 | 0.008 * |
FEV1/FVC ratio, mean ± SD | 57.8 ± 8.2 | 56.6 ± 9.0 | 58.6 ± 7.5 | 0.144 |
GOLD stage | 0.270 | |||
A | 24(17.5) | 9(16.4) | 15(18.3) | |
B | 22(16.1) | 8(14.5) | 14(17.1) | |
C | 12(8.8) | 2(3.6) | 10(12.2) | |
D | 79(57.7) | 36(65.5) | 43(52.4) | |
SpO2, mean ± SD | 94.4 ± 0.6 | 94.0 ± 2.0 | 94.7 ± 2.2 | 0.091 |
Oxygen Therapy (Yes) | 7(5.1) | 5(9.1) | 2(2.4) | 0.083 |
History of Hospitalized Exacerbation (Yes) | 85(62.0) | 43(78.2) | 42(51.2) | 0.001 * |
Depression (HAD-D ≥ 11) | 13(9.5) | 7(12.7) | 6(7.3) | 0.290 |
Non-pulmonary variables | ||||
Handgrip strength (kg), mean ± SD | 28.3 ± 8.0 | 27.5 ± 7.4 | 28.8 ± 8.3 | 0.327 |
Quadriceps strength (kg), mean ± SD | 15.7 ± 2.8 | 14.8 ± 2.9 | 16.3 ± 2.7 | 0.003 * |
Elbow strength (kg), mean ± SD | 15.0 ± 3.2 | 13.9 ± 2.4 | 15.7 ± 3.5 | 0.001 * |
6-min walk test (meters), mean ± SD | 349.1 ± 84.7 | 271.3 ± 69.8 | 403.3 ± 40.1 | 0.001 * |
SPPB score, mean ± SD | 9.5 ± 2.0 | 8.6 ± 1.9 | 10.1 ± 1.8 | 0.001 * |
5STS ≤ 2 | 75(54.7) | 42(76.4) | 33(40.2) | 0.001 * |
4MGS ≤ 3 | 45(32.8) | 29(52.7) | 16(19.5) | 0.001 * |
% activities with limitations | 21.6(17.5) | 3.8(1.9) | 1.5(1.3) | 0.001 * |
Predictors | Model 1 b | Final Model c |
---|---|---|
Smoking, pack-years | 1.00(0.99–1.02)0.323 | |
Current smoker | 1.35(0.54–3.41)0.517 | |
BMI | 0.86(0.48–1.55)0.622 | |
Number of comorbidities | 1.07(0.79–1.45)0.626 | |
Heart disease (yes) | 5.21(1.29–21.06)0.020 * | 6.07(1.56–23.49)0.009 * |
SpO2 | 0.80(0.64–1.01)0.063 t | 0.80(0.64–1.00)0.054 t |
Dyspnea(mMRC ≥ 2) | 2.51(1.09–6.34)0.048 * | |
Exacerbations ≥2 | 1.60(0.67–3.80)0.288 | |
CAT ≥ 10 | 3.88(1.37–10.93)0.010 * | |
FEV1 (% of predicted) | 0.97(0.94–0.99)0.036 * | |
GOLD | 0.010 | |
A | Ref. | |
B | 2.07(0.39–10.80)0.386 | |
C | 1.07(0.13–8.55)0.947 | |
D | 6.68(1.76–25.39)0.005 * | |
History of Hospitalized Exacerbation (Yes) | 1.39(0.58–3.33)0.460 | |
Depression (HAD-D ≥ 11) | 3.13(0.93–10.46)0.063 t | 3.87(1.19–12.49)0.024 * |
Predictors | Model 1 b | Model 2 c | Final Model d |
---|---|---|---|
Handgrip strength (kg) | 0.96(0.88–1.04)0.369 | 0.97(0.91–1.03)0.359 | |
Quadriceps strength (kg) | 0.83(0.70–0.99)0.048 * | 0.85(0.71–1.01)0.073 t | |
Elbow strength (kg) | 1.04(0.86–1.24)0.661 | 1.00(0.85–1.17)0.963 | |
SPPB (range 0 ± 12) | 0.77(0.58–1.03)0.082 | 0.79(0.59–1.06)0.123 | |
5STS ≤ 2 | 3.88(1.51–10.00)0.005 * | 2.80(1.10–7.10)0.030 * | 3.01(1.22–7.42)0.016 * |
4MGS ≤ 3 | 1.60(0.60–4.26)0.338 | 1.85(0.68–5.06)0.226 | |
Self-reported questionnaire (0 ± 100) | 1.04(1.00–1.07)0.011 * | 1.02(0.99–1.06)0.010 * | 1.03(1.00–1.07)0.015 * |
<350 m at Baseline | ≥350 m at Baseline | |||||
---|---|---|---|---|---|---|
Predictors | Stable at 2 Years (n = 56) | Unstable (Improvement) at 2 Years (n = 14) | p-Value | Stable at 2 Years (n = 29) | Unstable (Worsening) at 2 Years (n = 19) | p-Value |
% activities with limitations | 2.29(20.93) | 2.61(22.98) | 0.964 | −2.55(10.99) | 7.01(20.05) | 0.060 |
5STS (s) | −0.22(3.12) | −1.51(1.79) | 0.199 | −1.10(2.15) | −0.33(3.16) | 0.269 |
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Sánchez-Martínez, M.P.; Bernabeu-Mora, R.; Martínez-González, M.; Gacto-Sánchez, M.; Martín San Agustín, R.; Medina-Mirapeix, F. Stability and Predictors of Poor 6-min Walking Test Performance over 2 Years in Patients with COPD. J. Clin. Med. 2020, 9, 1155. https://doi.org/10.3390/jcm9041155
Sánchez-Martínez MP, Bernabeu-Mora R, Martínez-González M, Gacto-Sánchez M, Martín San Agustín R, Medina-Mirapeix F. Stability and Predictors of Poor 6-min Walking Test Performance over 2 Years in Patients with COPD. Journal of Clinical Medicine. 2020; 9(4):1155. https://doi.org/10.3390/jcm9041155
Chicago/Turabian StyleSánchez-Martínez, Mª Piedad, Roberto Bernabeu-Mora, Mariano Martínez-González, Mariano Gacto-Sánchez, Rodrigo Martín San Agustín, and Francesc Medina-Mirapeix. 2020. "Stability and Predictors of Poor 6-min Walking Test Performance over 2 Years in Patients with COPD" Journal of Clinical Medicine 9, no. 4: 1155. https://doi.org/10.3390/jcm9041155