Determination of the minimal important difference for inspiratory muscle strength in people with severe and very severe COPD.
Clin Rehabil
; 37(11): 1521-1532, 2023 Nov.
Article
em En
| MEDLINE
| ID: mdl-37186772
ABSTRACT
OBJECTIVE:
Inspiratory muscle training is recommended for people with chronic obstructive pulmonary disease (COPD) with inspiratory muscle weakness. Clinical interpretation of changes in inspiratory muscle strength could be helped by the determination of cut-off values. The aim of this study was to estimate the minimal important difference for inspiratory muscle strength assessed with maximal inspiratory pressure (MIP) in people with COPD.DESIGN:
Post hoc analysis of a randomized controlled trial (EMI2 study) including people with severe to very severe COPD undergoing a pulmonary rehabilitation program was conducted. The determination of the minimal important difference was realized using both anchor-based and distribution-based methods.SETTING:
The study includes patients admitted to the rehabilitation program unit of the Centre Hospitalier des Pays de Morlaix (Morlaix, France) between March 5, 2014 and September 8, 2016.PARTICIPANTS:
Seventy-three people with severe to very severe COPD (age 62.2 ± 8.0 years, forced expiratory volume in 1â s 36.4 ± 9.5% of theoretical) were analyzed. INTERVENTION Patients followed a standardized pulmonary rehabilitation program 5 days a week for 4 weeks. The program included aerobic training, ground-based outdoor walking training, and strengthening of lower and upper limb muscles. MAINMEASURES:
At the end of the pulmonary rehabilitation program, MIP improved by 14.8 ± 14.9 cmH2O (p < 0.05). Regarding the anchor-based method, only the modified Medical Research Council was selected as an appropriate anchor. The receiver operating characteristic curve analysis reported a minimal important difference of 13.5 cmH2O (sensibility 75% specificity 67.5%). Using distribution-based methods, the estimate of minimal important difference was 7.9 cmH2O (standard error of measurement method) and 10.9 cmH2O (size effect method).RESULTS:
The estimations proposed by this study ranged from 7.9 to 13.5 cmH2O.CONCLUSIONS:
The measurement of minimal important difference is a simple tool for assessing the changes of inspiratory muscle strength during a pulmonary rehabilitation program. We propose a minimal important difference of 13.5 cmH2O for the improvement of MIP. Further studies are needed to confirm this estimation.ClinicalTrials.gov identifier NCT02074813.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Doença Pulmonar Obstrutiva Crônica
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
Limite:
Aged
/
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article