METHODS: We included patients with severe COPD who were eligible for BLVR-EBV and PR. Participants were randomized into three groups: PR before BLVR-EBV, PR after BLVR-EBV or BLVR-EBV without PR. The primary outcome was change in constant work rate cycle test (CWRT) endurance time at 6-month follow-up of the PR groups compared to BLVR-EBV alone. Secondary endpoints included changes in 6-minute walking test, daily step count, dyspnoea and health-related quality of life.
RESULTS: Ninety-seven participants were included. At 6-month follow-up, there was no difference in change in CWRT endurance time between the PR before BLVR-EBV and BLVR-EBV alone groups (median: 421 [IQR: 44; 1304] vs. 787 [123; 1024] seconds, p = 0.82) or in any of the secondary endpoints, but the PR after BLVR-EBV group exhibited a smaller improvement in CWRT endurance time (median: 107 [IQR: 2; 573], p = 0.04) and health-related quality of life compared to BLVR-EBV alone.
CONCLUSIONS: The addition of PR to BLVR-EBV did not result in increased exercise capacity, daily step count or improved patient-reported outcomes compared to BLVR-EBV alone, neither when PR was administered before BLVR-EBV nor when PR was administered after BLVR-EBV.
方法:我们纳入符合BLVR-EBV和PR的重度COPD患者。参与者被随机分为三组:在BLVR-EBV之前进行PR,BLVR-EBV或无PR的BLVR-EBV后的PR。与单独的BLVR-EBV相比,主要结果是PR组6个月随访时恒定工作速率循环测试(CWRT)耐力时间的变化。次要终点包括6分钟步行测试的变化,每日步数,呼吸困难和健康相关的生活质量。
结果:97名参与者被纳入。在6个月的随访中,在BLVR-EBV之前的PR和单独的BLVR-EBV组之间,CWRT耐力时间的变化没有差异(中位数:421[IQR:44;1304]vs.787[123;1024]秒,p=0.82)或在任何次要终点,但BLVR-EBV组的PR显示CWRT耐久时间的改善较小(中位数:107[IQR:2;573],p=0.04)和与单独BLVR-EBV相比的健康相关生活质量。
结论:在BLVR-EBV中添加PR并没有导致运动能力增加,与单独使用BLVR-EBV相比,每日步数或患者报告的结局得到改善,无论是在BLVR-EBV之前施用PR还是在BLVR-EBV之后施用PR。