Mean (SE) endurance times resulting from the combination of tiotropium and pulmonary rehabilitation in the subgroup of patients who completed the activity questionnaire

Patients receiving tiotropium continued to increase their measured exercise endurance during the 12-week period following pulmonary rehabilitation.<p><b>Copyright information:</b></p><p>Taken from "Improvement in self-reported exercise participation with the combination of tiotropium and rehabilitative exercise training in COPD patients"</p><p></p><p>International Journal of Chronic Obstructive Pulmonary Disease 2008;3(1):127-136.</p><p>Published online Jan 2008</p><p>PMCID:PMC2528216.</p><p>© 2008 Kesten et al, publisher and licensee Dove Medical Press Ltd.</p

相対作用素エントロピーをめぐって(作用素不等式とその周辺)

Independent Ethics Committees and Institutional Review Boards for ClinicalTrial.gov: NCT01072396. (PDF 71 kb

Improvement in self-reported exercise participation with the combination of tiotropium and rehabilitative exercise training in COPD patients-0

<p><b>Copyright information:</b></p><p>Taken from "Improvement in self-reported exercise participation with the combination of tiotropium and rehabilitative exercise training in COPD patients"</p><p></p><p>International Journal of Chronic Obstructive Pulmonary Disease 2008;3(1):127-136.</p><p>Published online Jan 2008</p><p>PMCID:PMC2528216.</p><p>© 2008 Kesten et al, publisher and licensee Dove Medical Press Ltd.</p

Mean (SE) difference in duration of activities from week 4 (prior to pulmonary rehabilitation) to subsequent visits as reported through the activity questionnaire

Patients receiving tiotropium reported on average 262 minutes more exercise at the end of the study whereas patients receiving placebo reported a gain of only 60 minutes.<p><b>Copyright information:</b></p><p>Taken from "Improvement in self-reported exercise participation with the combination of tiotropium and rehabilitative exercise training in COPD patients"</p><p></p><p>International Journal of Chronic Obstructive Pulmonary Disease 2008;3(1):127-136.</p><p>Published online Jan 2008</p><p>PMCID:PMC2528216.</p><p>© 2008 Kesten et al, publisher and licensee Dove Medical Press Ltd.</p

Cluster Analysis in Patients with GOLD 1 Chronic Obstructive Pulmonary Disease

<div><p>Background</p><p>We hypothesized that heterogeneity exists within the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 1 spirometric category and that different subgroups could be identified within this GOLD category.</p><p>Methods</p><p>Pre-randomization study participants from two clinical trials were symptomatic/asymptomatic GOLD 1 chronic obstructive pulmonary disease (COPD) patients and healthy controls. A hierarchical cluster analysis used pre-randomization demographics, symptom scores, lung function, peak exercise response and daily physical activity levels to derive population subgroups.</p><p>Results</p><p>Considerable heterogeneity existed for clinical variables among patients with GOLD 1 COPD. All parameters, except forced expiratory volume in 1 second (FEV₁)/forced vital capacity (FVC), had considerable overlap between GOLD 1 COPD and controls. Three-clusters were identified: cluster I (18 [15%] COPD patients; 105 [85%] controls); cluster II (45 [80%] COPD patients; 11 [20%] controls); and cluster III (22 [92%] COPD patients; 2 [8%] controls). Apart from reduced diffusion capacity and lower baseline dyspnea index versus controls, cluster I COPD patients had otherwise preserved lung volumes, exercise capacity and physical activity levels. Cluster II COPD patients had a higher smoking history and greater hyperinflation versus cluster I COPD patients. Cluster III COPD patients had reduced physical activity versus controls and clusters I and II COPD patients, and lower FEV₁/FVC versus clusters I and II COPD patients.</p><p>Conclusions</p><p>The results emphasize heterogeneity within GOLD 1 COPD, supporting an individualized therapeutic approach to patients.</p><p>Trial registration</p><p>www.clinicaltrials.gov. <a href="https://clinicaltrials.gov/ct2/show/NCT01360788" target="_blank">NCT01360788</a> and <a href="https://clinicaltrials.gov/ct2/show/NCT01072396" target="_blank">NCT01072396</a>.</p></div

V′o_{2 peak} relative to body weight and daily physical activity levels by cluster.

<p>a) Peak oxygen consumption (V′o_{2 peak}) relative to body weight; b) mean steps per day; c) mean daily energy expenditure (EE); d) mean daily time >3 metabolic equivalents (METs); and e) baseline dyspnea index (BDI) score by cluster of patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 1 chronic obstructive pulmonary disease. Values are mean ± SD. Dashed lines represent mean values in control subjects. *p<0.01 versus controls subjects; ^†p<0.05 versus cluster I and II.</p

Proportion of controls subjects and patients with GOLD grade 1 COPD within each cluster.

<p>Proportion of controls subjects and patients with GOLD grade 1 COPD within each cluster.</p

Frequency distributions for pulmonary function, peak V′o₂, BDI score and physical activity.

<p>a) forced expiratory volume in 1 second (FEV₁); b) FEV₁/forced vital capacity (FVC) ratio; c) total lung capacity (TLC); d) functional residual capacity (FRC); e) residual volume (RV); f) diffusion capacity (<i>D</i>lco); g) peak oxygen uptake (V′o₂ peak); h) baseline dyspnea index (BDI) score; i) number of steps per day; j) and daily time spent in physical activity >3 metabolic equivalents (METs). GOLD: Global Initiative for Chronic Obstructive Lung Disease.</p

Pulmonary function parameters expressed as percentage of predicted values by cluster.

<p>a) forced expiratory volume in 1 second (FEV₁); b) total lung capacity (TLC); c) functional residual volume (FRC); d) residual volume (RV); and e) diffusion capacity (<i>D</i>lco); as well as f) FEV₁/forced vital capacity (FVC) ratio by cluster of patients with Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 1 chronic obstructive pulmonary disease. Values are mean ± SD. Dashed lines represent mean values in control subjects. *p<0.01 versus healthy controls; ^†p<0.05 versus cluster I; ^‡p<0.01 versus cluster I and II.</p

Intensity ratings of (A) dyspnea and (B) leg discomfort versus work rate during incremental treadmill exercise.

<p>Data are shown as mean ± standard error. *p<0.05 GOLD 1 and GOLD 2 versus controls at a standardized work rate; ^#p<0.05 GOLD 1 versus controls (confidence intervals do not overlap indicating p<0.05).</p