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Cited by 61Chronic Obstructive Pulmonary Disease (COPD) ResearchCardiovascular and exercise physiologyCystic Fibrosis Research Advances

Fatigue in COPD: Prevalence and effect on outcomes in pulmonary rehabilitation

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Baltzan, Marcel A, Scott, Adrienne S, Wolkove, Norman, Bailes, Sally, Bernard, Sarah, Bourbeau, Jean, Maltais, François, Canadian COPD Pulmonary Rehabilitation Research Group·2011·Chronic Respiratory Disease
DOI 10.1177/1479972310396737
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Abstract

Patients with chronic obstructive pulmonary disease (COPD) complain of dyspnea and fatigue. We sought to estimate the prevalence of high fatigue in this population and to determine whether individuals with high fatigue had a different response to pulmonary rehabilitation. This observational study was embedded within a randomized trial. Participants underwent 3 months of pulmonary rehabilitation including education and exercise training. We divided 251 individuals into low and high fatigue groups using population normal scores of the SF-36 vitality domain. Baseline data included spirometry, 6-minute walk distance (6MWD), peak exercise capacity, constant workrate cycling endurance time, and questionnaires including the St. George’s and Chronic Respiratory questionnaires (SGRQ, CRQ). The response to pulmonary rehabilitation was evaluated using changes in these measures at 3 months and 1 year after entry. High fatigue was present in 97/251 (39%) of patients. High fatigue patients were younger, had more depressive symptoms, greater dyspnea and poorer SGRQ scores (p < 0.01). They also had lower 6MWD, endurance times, and peak volume of oxygen consumption (VO 2; p < 0.05). Patients in both groups improved similarly in their dyspnea, the 6MWD and endurance time. High-fatigue patients had greater improvements in both the CRQ fatigue (by 0.74 more points) and the SGRQ scores (by 6.0 points; p < 0.01), with clinically significant gains maintained at 1 year. This study suggests that high levels of fatigue is a common feature in patients with COPD. They have a lower exercise capacity and a lower health status. However, they benefit from pulmonary rehabilitation.

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  • Patients with intractable breathlessness are commonly fatigued, which limits capacity to retain and process new information.

    “Patients with intractable breathlessness are commonly fatigued, which limits the capacity to retain and process new information.”

    From The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease (2017) · cites this paper as [41]

    The Abstract and Discussion (page unavailable) report that fatigue is common among patients with COPD and that patients with high fatigue had greater dyspnea. The Introduction says fatigue may limit participation in rehabilitation activities, but the paper does not establish that it limits patients’ capacity to retain and process new information. (LLM, conf=0.85)

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Research works printed but not linked: 5

  1. Lamb J, Borycki E, and Marciniuk D. Energy conser- vation and fatigue. In: Bourbeau J, Nault D, Borycki E (eds) Comprehensive management of chronic obstruc- tive pulmonary disease. PMPH-USA: Shelton, CT; 2002: 171-183.
  2. Decramer M, De Benedetto F, Del Ponte A, et al. Sys- temic effects of COPD. Respir Med 2005; 99: S3-S10.
  3. Maltais F, Bourbeau J, Shapiro S, et al. Effects of home-based versus outpatient hospital-based pulmon- ary rehabilitation in patients with COPD: a non- inferiority, randomized clinical trial. Ann Intern Med 2008; 149: 869-878.
  4. Hopman WM, Towheed T and Anastassiades T. Canadian normative data for the SF-36 health survey. CMAJ 2000; 163: 265-271.
  5. Ware JE, Kosinski M, and Keller SD. Interpretation: norm-based in SF-36 physical and mental health sum- mary scales: a user's manual. Boston: The Health Institute, New England Medical Center; 1994: 9-10.

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Authors
Baltzan, M. A., Scott, A. S., Wolkove, N., Bailes, S., Bernard, S., Bourbeau, J., Maltais, F., & Canadian COPD Pulmonary Rehabilitation Research Group
Affiliations
  • Mount Sinai Hospital Center, Montreal, Canada,
  • Mount Sinai Hospital Center, Montreal, Canada
  • Jewish General Hospital (CA)
  • Institut universitaire de cardiologie et de pneumologie de Québec (CA)
  • McGill University Health Centre (CA)
ORCID
Venue
Chronic Respiratory Disease
Publisher
SAGE Publications
Published
2011-03-23
Volume
8
Issue
2
Pages
119-128
ISSN
  • 1479-9723 (ISSN-L)
  • 1479-9731
DOI
10.1177/1479972310396737
OpenAlex
W2153919756
Cited by
61
References
50
Citations by year
2025: 5 · 2024: 4 · 2022: 3 · 2021: 8 · 2020: 2 · 2019: 6 · 2018: 2 · 2017: 6 · 2016: 4 · 2015: 5 · 2014: 2 · 2013: 6 · 2012: 8
FWCI
4.35
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Chronic Respiratory Disease (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Canadian Institutes of Health Research (MCT-63162)
  • Medical Research Council
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
Keywords
chronic obstructive pulmonary disease, fatigue, pulmonary rehabilitation, fatigue prevalence, exercise capacity, dyspnea, health-related quality of life, SF-36 vitality, 6-minute walk distance, depressive symptoms, treatment response
MeSH terms
Aged, Dyspnea, Exercise Test, Fatigue, Female, Health Status, Humans, Male, Middle Aged, Oxygen Consumption, Patient Education as Topic, Quality of Life, Surveys and Questionnaires, Exercise, Prevalence, Exercise Tolerance, Pulmonary Disease, Chronic Obstructive

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