The Science Journal of the American Association for Respiratory Care

2008 OPEN FORUM Abstracts


Ann Hart1Mark Zaleskiewicz1, Albert Rizzo1

Background: Timeliness of referral for patients diagnosed with COPD into a comprehensive Pulmonary Rehabilitation program (CPRP) has been a topic of discussion throughout the rehabilitation community. The advent of the BODE Index may allow a better perspective on when to refer patients to a CPRP who have limited access by the insurance carrier.

This was a retrospective study 49 COPD patients that enrolled in and completed our CPRP. Each patient completed all four components of the BODE Index during their initial and final exercise sessions. Patient's were placed in BODE quartiles by their entry score. Paired T-tests were than used to analyze pre and post changes in the BODE Index and its components for the overall population and individual quartiles.

Analysis of the entire study population (n = 49) by T-test reveals significant statistical differences (p < 0.05) for BODE Index (5.18; 4.10); 6-minute walk distance (261.47; 306.88); and MMRC (2.74; 2.10). Statistical significance (p > 0.05) was not met for either study population BMI (29.63; 29.78) or FEV-1% (42.90; 43.63). Quartile I (n = 7) analysis revealed statistical significance was not met (p > 0.05) for the BODE Index (1.43; 1.00), BMI (31.83; 31.87), FEV-1% (55.43; 63.29), MMRC (1.00; 1.00) or 6-minute walk distance (380.71; 04.71). Analysis of Quartile II (n = 11) showed a statistically significant change (p < 0.05) for 6-minute walk distance (286.36; 331.45) only, with statistical significance not being met (p > 0.05) for BMI (31.33; 31.37), FEV-1% (57.00; 54.36), MMRC (2.36; 1.82), or BODE (3.45; 2.91). Quartile III (n = 13) data revealed differences were statistically significant (p < 0.05) for MMRC (3.00; 2.08), 6-minute walk distance (289.31; 324.38) and BODE (5.31; 3.92), but not for either BMI (29.12; 29.39) or FEV-1% (40.23; 38.85). T-test analysis of Quartile IV (n = 18) showed statistically significant differences (p < 0.05) for MMRC (3.44; 2.72), 6-minute walk distance (286.36; 331.45) and BODE (7.61; 6.17). No statistically significant differences were noted in Quartile IV for either BMI (28.10; 28.28) or FEV-1% (31.33; 32.89).

The data suggests patients whose entry scores place them in quartiles III and IV may significantly improve both their BODE score and quartile placement while those in quartiles I and II remain stagnant. Therefore, waiting until COPD patients 'fall into' quartiles III or IV prior to referring them to a CPRP may be warranted.