OBJECTIVE: To investigate the effectiveness of pulmonary rehabilitation (PR) in exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD) with and without global fat-free mass (FFM) depletion.
DESIGN: Retrospective case-control.
SETTING: Outpatient clinic, university center.
PARTICIPANTS: All COPD patients referred to the PR program were stratified according their FFM status measured by bioelectrical impedance. They were considered depleted if FFM index was ≤ 15 kg/m(2) in women and ≤ 16 kg/m(2) in men. From this initial sample, all depleted patients (n=31) composed the FFM depleted group. It was composed predominantly by females (68%) with a mean age of 64.4±7.3yrs and forced expiratory volume in 1 second (FEV(1)) of 33.6±13.2% predicted. Paired for sex and age, 32 non-depleted patients were selected from the initial sample to compose the non-depleted group.
INTERVENTION: PR including whole-body and weight training during twelve weeks, three times/week.
MAIN OUTCOME MEASURES: St. George Respiratory Questionnaire (SGRQ), 6-minute walk distance (6-MWD) and FFM evaluation applied before and after PR.
RESULTS: Improvement in 6-MWD was similar in these two groups after PR. Both groups improved SGRQ, although the observed power was small and did not allow adequate comparison between depleted and non-depleted patients. There was no difference between groups in weight change whereas FFM tended to be greater in depleted patients. This increase had no correlation with 6-MWD or SGRQ.
CONCLUSION: Benefits of PR to exercise capacity were similar comparing FFM depleted and non-depleted COPD patients. Although FFM change tended to be greater in depleted patients, this increase had no definite relation with clinical outcomes.