DA Redelmeier, AM Bayoumi, RS Goldstein and GH Guyatt
Department of Medicine, The Program in Clinical Epidemiology and Health Care Research, University of Toronto, Ontario, Canada.

Functional status measurements are often difficult to interpret because small differences may be statistically significant but not clinically significant. How much does the Six Minute Walk test (6MW) need to differ to signify a noticeable difference in walking ability for patients with chronic obstructive pulmonary disease (COPD)? We studied individuals with stable COPD (n = 112, mean age = 67 yr, mean FEV1 = 975 ml) and estimated the smallest difference in 6MW distances that was associated with a noticeable difference in patients' subjective comparison ratings of their walking ability. We found that the 6MW was significantly correlated with patients' ratings of their walking ability relative to other patients (r = 0.59, 95% confidence interval [CI]: 0.54 to 0.63). Distances needed to differ by 54 m for the average patient to stop rating themselves as "about the same" and start rating themselves as either "a little bit better" or "a little bit worse" (95% CI: 37 to 71 m). We suggest that differences in functional status can be statistically significant but below the threshold at which patients notice a difference in themselves relative to others; an awareness of the smallest difference in walking distance that is noticeable to patients may help clinicians interpret the effectiveness of symptomatic treatments for COPD.

This article has been cited by other articles:

				M. Dallas, C. McCusker, M. Haggerty, C. Rochester, R. ZuWallack, and Northeast Pulmonary Rehabilitation Consortium Using pedometers to monitor walking activity in outcome assessment for pulmonary rehabilitation Chronic Respiratory Disease, November 1, 2009; 6(4): 217 - 224. [Abstract] [PDF]

				L. Puente-Maestu, F. Villar, J. de Miguel, W. W. Stringer, P. Sanz, M. L. Sanz, J. Garcia de Pedro, and Y. Martinez-Abad Clinical relevance of constant power exercise duration changes in COPD Eur. Respir. J., August 1, 2009; 34(2): 340 - 345. [Abstract] [Full Text] [PDF]

				S. Costi, E. Crisafulli, F. D. Antoni, C. Beneventi, L. M. Fabbri, and E. M. Clini Effects of Unsupported Upper Extremity Exercise Training in Patients With COPD: A Randomized Clinical Trial Chest, August 1, 2009; 136(2): 387 - 395. [Abstract] [Full Text] [PDF]

				J. Garcia-Aymerich, I. Serra, F. P. Gomez, E. Farrero, E. Balcells, D. A. Rodriguez, J. de Batlle, E. Gimeno, D. Donaire-Gonzalez, M. Orozco-Levi, et al. Physical Activity and Clinical and Functional Status in COPD Chest, July 1, 2009; 136(1): 62 - 70. [Abstract] [Full Text] [PDF]

				D. B. Badesch, H. C. Champion, M. A. Gomez Sanchez, M. M. Hoeper, J. E. Loyd, A. Manes, M. McGoon, R. Naeije, H. Olschewski, R. J. Oudiz, et al. Diagnosis and assessment of pulmonary arterial hypertension. J. Am. Coll. Cardiol., June 30, 2009; 54(1 Suppl): S55 - S66. [Abstract] [Full Text] [PDF]

				K. E. Musselman, K. Fouad, J. E. Misiaszek, and J. F. Yang Training of Walking Skills Overground and on the Treadmill: Case Series on Individuals With Incomplete Spinal Cord Injury Physical Therapy, June 1, 2009; 89(6): 601 - 611. [Abstract] [Full Text] [PDF]

				S. H. Salzman The 6-Min Walk Test: Clinical and Research Role, Technique, Coding, and Reimbursement Chest, May 1, 2009; 135(5): 1345 - 1352. [Abstract] [Full Text] [PDF]

				A. Tang, K. M. Sibley, S. G. Thomas, M. T. Bayley, D. Richardson, W. E. McIlroy, and D. Brooks Effects of an Aerobic Exercise Program on Aerobic Capacity, Spatiotemporal Gait Parameters, and Functional Capacity in Subacute Stroke Neurorehabil Neural Repair, May 1, 2009; 23(4): 398 - 406. [Abstract] [PDF]

				A Steinsbekk and B. Lomundal Three-year follow-up after a two-year comprehensive pulmonary rehabilitation program Chronic Respiratory Disease, February 1, 2009; 6(1): 5 - 11. [Abstract] [PDF]

				K. Theander, P. Jakobsson, N. Jorgensen, and M. Unosson Effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease: a randomized controlled trial Clinical Rehabilitation, February 1, 2009; 23(2): 125 - 136. [Abstract] [PDF]

				A. Ferreira, C. Garvey, G. L. Connors, L. Hilling, J. Rigler, S. Farrell, C. Cayou, C. Shariat, and H. R. Collard Pulmonary Rehabilitation in Interstitial Lung Disease: Benefits and Predictors of Response Chest, February 1, 2009; 135(2): 442 - 447. [Abstract] [Full Text] [PDF]

				W. Weder, M. Tutic, D. Lardinois, W. Jungraithmayr, S. Hillinger, E. W. Russi, and K. E. Bloch Persistent Benefit From Lung Volume Reduction Surgery in Patients With Homogeneous Emphysema Ann. Thorac. Surg., January 1, 2009; 87(1): 229 - 237. [Abstract] [Full Text] [PDF]

				C. Gilbert, M. C. J. Brown, J. C. Cappelleri, M. Carlsson, and S. P. McKenna Estimating a Minimally Important Difference in Pulmonary Arterial Hypertension Following Treatment With Sildenafil Chest, January 1, 2009; 135(1): 137 - 142. [Abstract] [Full Text] [PDF]

				L. A. Clarke, J. E. Wraith, M. Beck, E. H. Kolodny, G. M. Pastores, J. Muenzer, D. M. Rapoport, K. I. Berger, M. Sidman, E. D. Kakkis, et al. Long-term Efficacy and Safety of Laronidase in the Treatment of Mucopolysaccharidosis I Pediatrics, January 1, 2009; 123(1): 229 - 240. [Abstract] [Full Text] [PDF]

				F. Maltais, J. Bourbeau, S. Shapiro, Y. Lacasse, H. Perrault, M. Baltzan, P. Hernandez, M. Rouleau, M. Julien, S. Parenteau, et al. Effects of Home-Based Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease: A Randomized Trial Ann Intern Med, December 16, 2008; 149(12): 869 - 878. [Abstract] [Full Text] [PDF]

				A. Chaouat, R. Naeije, and E. Weitzenblum Pulmonary hypertension in COPD Eur. Respir. J., November 1, 2008; 32(5): 1371 - 1385. [Abstract] [Full Text] [PDF]

				F Bauer, F Mghaieth, N Dervaux, E Donal, G Derumeaux, A Cribier, and J-P Bessou Preoperative tissue Doppler imaging differentiates beneficial from detrimental left ventricular hypertrophy in patients with surgical aortic stenosis. A postoperative morbidity study Heart, November 1, 2008; 94(11): 1440 - 1445. [Abstract] [Full Text] [PDF]

				J. W LeMaster, M. J Mueller, G. E Reiber, D. R Mehr, R. W Madsen, and V. S Conn Effect of Weight-Bearing Activity on Foot Ulcer Incidence in People With Diabetic Peripheral Neuropathy: Feet First Randomized Controlled Trial Physical Therapy, November 1, 2008; 88(11): 1385 - 1398. [Abstract] [Full Text] [PDF]

				A. Majid, J. Guerrero, S. Gangadharan, D. Feller-Kopman, P. Boiselle, M. DeCamp, S. Ashiku, G. Michaud, F. Herth, and A. Ernst Tracheobronchoplasty for Severe Tracheobronchomalacia: A Prospective Outcome Analysis Chest, October 1, 2008; 134(4): 801 - 807. [Abstract] [Full Text] [PDF]

				O. Kowal-Bielecka, M. Delcroix, A. Vonk-Noordegraaf, M. M. Hoeper, and R. Naeije Outcome measures in pulmonary arterial hypertension associated with systemic sclerosis Rheumatology, October 1, 2008; 47(suppl_5): v39 - v41. [Abstract] [Full Text] [PDF]

				H. A. Ghofrani, M. W. Wilkins, and S. Rich Uncertainties in the Diagnosis and Treatment of Pulmonary Arterial Hypertension Circulation, September 9, 2008; 118(11): 1195 - 1201. [Abstract] [Full Text] [PDF]

				M. A. Puhan, M. J. Mador, U. Held, R. Goldstein, G. H. Guyatt, and H. J. Schunemann Interpretation of treatment changes in 6-minute walk distance in patients with COPD Eur. Respir. J., September 1, 2008; 32(3): 637 - 643. [Abstract] [Full Text] [PDF]

				F. Di Meo, C. Pedone, S. Lubich, C. Pizzoli, M. Traballesi, and R. A. Incalzi Age does not hamper the response to pulmonary rehabilitation of COPD patients Age Ageing, September 1, 2008; 37(5): 530 - 535. [Abstract] [Full Text] [PDF]

				S J Singh, P W Jones, R Evans, and M D L Morgan Minimum clinically important improvement for the incremental shuttle walking test Thorax, September 1, 2008; 63(9): 775 - 777. [Abstract] [Full Text] [PDF]

				G. Faager, A. Stahle, and F. Larsen Influence of spontaneous pursed lips breathing on walking endurance and oxygen saturation in patients with moderate to severe chronic obstructive pulmonary disease Clinical Rehabilitation, August 1, 2008; 22(8): 675 - 683. [Abstract] [PDF]

				P P Walker, A Burnett, P W Flavahan, and P M A Calverley Lower limb activity and its determinants in COPD Thorax, August 1, 2008; 63(8): 683 - 689. [Abstract] [Full Text] [PDF]

				E Crisafulli, S Costi, F Luppi, G Cirelli, C Cilione, O Coletti, L M Fabbri, and E M Clini Role of comorbidities in a cohort of patients with COPD undergoing pulmonary rehabilitation Thorax, June 1, 2008; 63(6): 487 - 492. [Abstract] [Full Text] [PDF]

				T. Steffen and M. Seney Test-Retest Reliability and Minimal Detectable Change on Balance and Ambulation Tests, the 36-Item Short-Form Health Survey, and the Unified Parkinson Disease Rating Scale in People With Parkinsonism Physical Therapy, June 1, 2008; 88(6): 733 - 746. [Abstract] [Full Text] [PDF]

				C. G. Cote, C. Casanova, J. M. Marin, M. V. Lopez, V. Pinto-Plata, M. M. de Oca, L. J. Dordelly, H. Nekach, and B. R. Celli Validation and comparison of reference equations for the 6-min walk distance test Eur. Respir. J., March 1, 2008; 31(3): 571 - 578. [Abstract] [Full Text] [PDF]

				S. Jenkins Which is the best exercise test to assess therapeutic intervention in COPD? Chronic Respiratory Disease, February 1, 2008; 5(1): 3 - 5. [PDF]

				M. Cazzola, W. MacNee, F. J. Martinez, K. F. Rabe, L. G. Franciosi, P. J. Barnes, V. Brusasco, P. S. Burge, P. M. A. Calverley, B. R. Celli, et al. Outcomes for COPD pharmacological trials: from lung function to biomarkers Eur. Respir. J., February 1, 2008; 31(2): 416 - 469. [Abstract] [Full Text] [PDF]

				C. Brophy, J. Kastelik, E. Gardiner, and M. Greenstone Quality of life measurements and bronchodilator responsiveness in prescribing nebulizer therapy in COPD Chronic Respiratory Disease, February 1, 2008; 5(1): 13 - 18. [Abstract] [PDF]

				L Laviolette, J Bourbeau, S Bernard, Y Lacasse, V Pepin, M-J Breton, M Baltzan, M Rouleau, and F Maltais Assessing the impact of pulmonary rehabilitation on functional status in COPD Thorax, February 1, 2008; 63(2): 115 - 121. [Abstract] [Full Text] [PDF]

				C. Fiorina, E. Vizzardi, R. Lorusso, M. Maggio, G. De Cicco, S. Nodari, P. Faggiano, and L. Dei Cas The 6-min walking test early after cardiac surgery. Reference values and the effects of rehabilitation programme Eur. J. Cardiothorac. Surg., November 1, 2007; 32(5): 724 - 729. [Abstract] [Full Text] [PDF]

				A. Ernst, A. Majid, D. Feller-Kopman, J. Guerrero, P. Boiselle, S. H. Loring, C. O'Donnell, M. DeCamp, F. J. F. Herth, S. Gangadharan, et al. Airway Stabilization With Silicone Stents for Treating Adult Tracheobronchomalacia: A Prospective Observational Study Chest, August 1, 2007; 132(2): 609 - 616. [Abstract] [Full Text] [PDF]

				S J Quantrill, R White, A Crawford, J S Barry, S Batra, P Whyte, and C M Roberts Short burst oxygen therapy after activities of daily living in the home in chronic obstructive pulmonary disease Thorax, August 1, 2007; 62(8): 702 - 705. [Abstract] [Full Text] [PDF]

				S. J. Carr, R. S. Goldstein, and D. Brooks Acute Exacerbations of COPD in Subjects Completing Pulmonary Rehabilitation Chest, July 1, 2007; 132(1): 127 - 134. [Abstract] [Full Text] [PDF]

				D. D. Marciniuk, S. J. Butcher, J. K. Reid, G. F. MacDonald, N. D. Eves, R. Clemens, and R. L. Jones The Effects of Helium-Hyperoxia on 6-min Walking Distance in COPD: A Randomized, Controlled Trial Chest, June 1, 2007; 131(6): 1659 - 1665. [Abstract] [Full Text] [PDF]

				A. Rampello and A. Chetta Author Response Physical Therapy, May 1, 2007; 87(5): 558 - 559. [Full Text] [PDF]

				E. Crisafulli, S. Costi, F. De Blasio, G. Biscione, F. Americi, S. Penza, E. Eutropio, F. Pasqua, L. M. Fabbri, and E. M. Clini Effects of a Walking Aid in COPD Patients Receiving Oxygen Therapy Chest, April 1, 2007; 131(4): 1068 - 1074. [Abstract] [Full Text] [PDF]

				V. Pepin, J. Brodeur, Y. Lacasse, J. Milot, P. LeBlanc, F. Whittom, and F. Maltais Six-minute walking versus shuttle walking: responsiveness to bronchodilation in chronic obstructive pulmonary disease Thorax, April 1, 2007; 62(4): 291 - 298. [Abstract] [Full Text] [PDF]

				C. D. Fell and F. J. Martinez The Impact of Pulmonary Arterial Hypertension on Idiopathic Pulmonary Fibrosis Chest, March 1, 2007; 131(3): 641 - 643. [Full Text] [PDF]

				C. Casanova, C. G. Cote, J. M. Marin, J. P. de Torres, A. Aguirre-Jaime, R. Mendez, L. Dordelly, and B. R. Celli The 6-min walking distance: long-term follow up in patients with COPD Eur. Respir. J., March 1, 2007; 29(3): 535 - 540. [Abstract] [Full Text] [PDF]

				S J Singh and M D. Morgan How long should a course of rehabilitation be? Chronic Respiratory Disease, February 1, 2007; 4(1): 3 - 4. [PDF]

				S Skumlien, E A Skogedal, O Bjortuft, and M S Ryg Four weeks' intensive rehabilitation generates significant health effects in COPD patients Chronic Respiratory Disease, February 1, 2007; 4(1): 5 - 13. [Abstract] [PDF]

				P. Palange, S. A. Ward, K-H. Carlsen, R. Casaburi, C. G. Gallagher, R. Gosselink, D. E. O'Donnell, L. Puente-Maestu, A. M. Schols, S. Singh, et al. Recommendations on the use of exercise testing in clinical practice Eur. Respir. J., January 1, 2007; 29(1): 185 - 209. [Abstract] [Full Text] [PDF]

				D. E. Wood, R. J. McKenna Jr, R. D. Yusen, D. H. Sterman, D. E. Ost, S. C. Springmeyer, H. X. Gonzalez, M. S. Mulligan, T. Gildea, W. V. Houck, et al. A multicenter trial of an intrabronchial valve for treatment of severe emphysema J. Thorac. Cardiovasc. Surg., January 1, 2007; 133(1): 65 - 73. [Abstract] [Full Text] [PDF]

				D. D. Sin, E. Wong, I. Mayers, D. C. Lien, D. Feeny, H. Cheung, W. Q. Gan, and S. F. P. Man Effects of Nocturnal Noninvasive Mechanical Ventilation on Heart Rate Variability of Patients With Advanced COPD Chest, January 1, 2007; 131(1): 156 - 163. [Abstract] [Full Text] [PDF]

				J. M. Bradley, T. Lasserson, S. Elborn, J. MacMahon, and B. O'Neill A Systematic Review of Randomized Controlled Trials Examining the Short-term Benefit of Ambulatory Oxygen in COPD Chest, January 1, 2007; 131(1): 278 - 285. [Abstract] [Full Text] [PDF]

				M. A. Puhan, G. Busching, H. J. Schunemann, E. vanOort, C. Zaugg, and M. Frey Interval versus Continuous High-Intensity Exercise in Chronic Obstructive Pulmonary Disease: A Randomized Trial Ann Intern Med, December 5, 2006; 145(11): 816 - 825. [Abstract] [Full Text] [PDF]

				A. M. Cheung, C. M. Tansey, G. Tomlinson, N. Diaz-Granados, A. Matte, A. Barr, S. Mehta, C. D. Mazer, C. B. Guest, T. E. Stewart, et al. Two-Year Outcomes, Health Care Use, and Costs of Survivors of Acute Respiratory Distress Syndrome Am. J. Respir. Crit. Care Med., September 1, 2006; 174(5): 538 - 544. [Abstract] [Full Text] [PDF]

				K. S. Naunheim, D. E. Wood, Z. Mohsenifar, A. L. Sternberg, G. J. Criner, M. M. DeCamp, C. C. Deschamps, F. J. Martinez, F. C. Sciurba, J. Tonascia, et al. Long-Term Follow-Up of Patients Receiving Lung-Volume-Reduction Surgery Versus Medical Therapy for Severe Emphysema by the National Emphysema Treatment Trial Research Group Ann. Thorac. Surg., August 1, 2006; 82(2): 431 - 443. [Abstract] [Full Text] [PDF]

				W. M. Chatila, E. A. Hoffman, J. Gaughan, G. B. Robinswood, G. J. Criner, and for the National Emphysema Treatment Trial Researc Advanced emphysema in african-american and white patients: do differences exist? Chest, July 1, 2006; 130(1): 108 - 118. [Abstract] [Full Text] [PDF]

				H. G. de Oliveira, A. V. Macedo-Neto, A. B. John, S. Jungblut, J. C. Prolla, S. S. Menna-Barreto, and E. A. F. Fortis Transbronchoscopic Pulmonary Emphysema Treatment: 1-Month to 24-Month Endoscopic Follow-up. Chest, July 1, 2006; 130(1): 190 - 199. [Abstract] [Full Text] [PDF]

				K. Hill, S. C. Jenkins, D. L. Philippe, N. Cecins, K. L. Shepherd, D. J. Green, D. R. Hillman, and P. R. Eastwood High-intensity inspiratory muscle training in COPD. Eur. Respir. J., June 1, 2006; 27(6): 1119 - 1128. [Abstract] [Full Text] [PDF]

				C. Andersson, L. Asztalos, and E. Mattsson Six-minute walk test in adults with cerebral palsy. A study of reliability Clinical Rehabilitation, June 1, 2006; 20(6): 488 - 495. [Abstract] [PDF]

				I. Vivodtzev, J.-L. Pepin, G. Vottero, V. Mayer, B. Porsin, P. Levy, and B. Wuyam Improvement in Quadriceps Strength and Dyspnea in Daily Tasks After 1 Month of Electrical Stimulation in Severely Deconditioned and Malnourished COPD Chest, June 1, 2006; 129(6): 1540 - 1548. [Abstract] [Full Text] [PDF]

				N. K. Leidy Evolving Concepts in the Measurement of Treatment Effects Proceedings of the ATS, May 1, 2006; 3(3): 212 - 217. [Abstract] [Full Text] [PDF]

				R. Leigh, M. M. M. Pizzichini, M. M. Morris, F. Maltais, F. E. Hargreave, and E. Pizzichini Stable COPD: predicting benefit from high-dose inhaled corticosteroid treatment Eur. Respir. J., May 1, 2006; 27(5): 964 - 971. [Abstract] [Full Text] [PDF]

				P. W. Jones and A. G. N. Agusti Outcomes and markers in the assessment of chronic obstructive pulmonary disease. Eur. Respir. J., April 1, 2006; 27(4): 822 - 832. [Abstract] [Full Text] [PDF]

				R. Guell, V. Resqueti, M. Sangenis, F. Morante, B. Martorell, P. Casan, and G. H. Guyatt Impact of Pulmonary Rehabilitation on Psychosocial Morbidity in Patients With Severe COPD. Chest, April 1, 2006; 129(4): 899 - 904. [Abstract] [Full Text] [PDF]

				R. Garrod, J. Marshall, E. Barley, and P. W. Jones Predictors of success and failure in pulmonary rehabilitation Eur. Respir. J., April 1, 2006; 27(4): 788 - 794. [Abstract] [Full Text] [PDF]

				J. D. Miller, R. A. Malthaner, C. H. Goldsmith, R. Goeree, D. Higgins, P. G. Cox, L. Tan, J. D. Road, and Canadian Lung Volume Reduction Surgery Study A Randomized Clinical Trial of Lung Volume Reduction Surgery Versus Best Medical Care for Patients With Advanced Emphysema: A Two-Year Study From Canada Ann. Thorac. Surg., January 1, 2006; 81(1): 314 - 321. [Abstract] [Full Text] [PDF]

				N. S. Hill Pulmonary rehabilitation. Proceedings of the ATS, January 1, 2006; 3(1): 66 - 74. [Abstract] [Full Text] [PDF]

				R. Casaburi and J. Porszasz Reduction of hyperinflation by pharmacologic and other interventions. Proceedings of the ATS, January 1, 2006; 3(2): 185 - 189. [Abstract] [Full Text] [PDF]

				D D Sin and S F P Man Skeletal muscle weakness, reduced exercise tolerance, and COPD: is systemic inflammation the missing link? Thorax, January 1, 2006; 61(1): 1 - 3. [Full Text] [PDF]

				O. Diaz, P. Begin, M. Andresen, M. E. Prieto, C. Castillo, J. Jorquera, and C. Lisboa Physiological and clinical effects of diurnal noninvasive ventilation in hypercapnic COPD Eur. Respir. J., December 1, 2005; 26(6): 1016 - 1023. [Abstract] [Full Text] [PDF]

				R. S. Goldstein Rehabilitation and the National Emphysema Treatment Trial Chest, December 1, 2005; 128(6): 3783 - 3784. [Full Text] [PDF]

				N. J. Gross Chronic Obstructive Pulmonary Disease Outcome Measurements: What's Important? What's Useful? Proceedings of the ATS, November 1, 2005; 2(4): 267 - 271. [Abstract] [Full Text] [PDF]

				M. Beckerman, R. Magadle, M. Weiner, and P. Weiner The Effects of 1 Year of Specific Inspiratory Muscle Training in Patients With COPD Chest, November 1, 2005; 128(5): 3177 - 3182. [Abstract] [Full Text] [PDF]

				G. Juan, M. Ramon, J. C. Valia, J. Cortijo, E. Rubio, E. Morcillo, and P. Calverley Palliative Treatment of Dyspnea With Epidural Methadone in Advanced Emphysema Chest, November 1, 2005; 128(5): 3322 - 3328. [Abstract] [Full Text] [PDF]

				C. G. Cote and B. R. Celli Pulmonary rehabilitation and the BODE index in COPD Eur. Respir. J., October 1, 2005; 26(4): 630 - 636. [Abstract] [Full Text] [PDF]

				D. Verrill, C. Barton, W. Beasley, and W. M. Lippard The Effects of Short-term and Long-term Pulmonary Rehabilitation on Functional Capacity, Perceived Dyspnea, and Quality of Life Chest, August 1, 2005; 128(2): 673 - 683. [Abstract] [Full Text] [PDF]

				K. K Mangione and K. M Palombaro Exercise Prescription for a Patient 3 Months After Hip Fracture Physical Therapy, July 1, 2005; 85(7): 676 - 687. [Abstract] [Full Text] [PDF]

				T. Troosters, R. Casaburi, R. Gosselink, and M. Decramer Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., July 1, 2005; 172(1): 19 - 38. [Full Text] [PDF]

				Y. Lacasse, R. Lecours, C. Pelletier, R. Begin, and F. Maltais Randomised trial of ambulatory oxygen in oxygen-dependent COPD Eur. Respir. J., June 1, 2005; 25(6): 1032 - 1038. [Abstract] [Full Text] [PDF]

				M A Puhan, H J Schunemann, M Frey, M Scharplatz, and L M Bachmann How should COPD patients exercise during respiratory rehabilitation? Comparison of exercise modalities and intensities to treat skeletal muscle dysfunction Thorax, May 1, 2005; 60(5): 367 - 375. [Abstract] [Full Text] [PDF]

				L. G. Olsson, K. Swedberg, A. L. Clark, K. K. Witte, and J. G.F. Cleland Six minute corridor walk test as an outcome measure for the assessment of treatment in randomized, blinded intervention trials of chronic heart failure: a systematic review Eur. Heart J., April 2, 2005; 26(8): 778 - 793. [Abstract] [Full Text] [PDF]

				T. Higenbottam Pulmonary Hypertension and Chronic Obstructive Pulmonary Disease: A Case for Treatment Proceedings of the ATS, April 1, 2005; 2(1): 12 - 19. [Abstract] [Full Text] [PDF]

				M Decramer, R Gosselink, P Bartsch, C-G Lofdahl, W Vincken, R Dekhuijzen, J Vestbo, R Pauwels, R Naeije, and T Troosters Effect of treatments on the progression of COPD: report of a workshop held in Leuven, 11-12 March 2004 Thorax, April 1, 2005; 60(4): 343 - 349. [Abstract] [Full Text] [PDF]

				G. Rossi, F. Florini, M. Romagnoli, T. Bellantone, S. Lucic, D. Lugli, and E. Clini Length and Clinical Effectiveness of Pulmonary Rehabilitation in Outpatients With Chronic Airway Obstruction Chest, January 1, 2005; 127(1): 105 - 109. [Abstract] [Full Text] [PDF]

				C. Opasich, S. De Feo, G. D. Pinna, G. Furgi, R. Pedretti, D. Scrutinio, and R. Tramarin Distance Walked in the 6-Minute Test Soon After Cardiac Surgery: Toward an Efficient Use in the Individual Patient Chest, December 1, 2004; 126(6): 1796 - 1801. [Abstract] [Full Text] [PDF]

				M. J. Mador, E. Bozkanat, A. Aggarwal, M. Shaffer, and T. J. Kufel Endurance and Strength Training in Patients With COPD Chest, June 1, 2004; 125(6): 2036 - 2045. [Abstract] [Full Text] [PDF]

				S M Revill Training options: one size fits all? Chronic Respiratory Disease, April 1, 2004; 1(2): 93 - 94. [PDF]

				J P Fuldl and M M Cotton Performance enhancement in chronic obstructive pulmonary disease Chronic Respiratory Disease, April 1, 2004; 1(2): 95 - 98. [Abstract] [PDF]

				B. R. Celli, C. G. Cote, J. M. Marin, C. Casanova, M. Montes de Oca, R. A. Mendez, V. Pinto Plata, and H. J. Cabral The Body-Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index in Chronic Obstructive Pulmonary Disease N. Engl. J. Med., March 4, 2004; 350(10): 1005 - 1012. [Abstract] [Full Text] [PDF]

				V.M. Pinto-Plata, C. Cote, H. Cabral, J. Taylor, and B.R. Celli The 6-min walk distance: change over time and value as a predictor of survival in severe COPD Eur. Respir. J., January 1, 2004; 23(1): 28 - 33. [Abstract] [Full Text] [PDF]

				M. Decramer Treatment of chronic respiratory failure: lung volume reduction surgery versus rehabilitation Eur. Respir. J., November 16, 2003; 22(47_suppl): 47s - 56s. [Abstract] [Full Text] [PDF]

				E. Monninkhof, P. van der Valk, J. van der Palen, C. van Herwaarden, and G. Zielhuis Effects of a comprehensive self-management programme in patients with chronic obstructive pulmonary disease Eur. Respir. J., November 1, 2003; 22(5): 815 - 820. [Abstract] [Full Text] [PDF]

				C.A. Lewis, T.E. Eaton, P. Young, and J. Kolbe Short-burst oxygen immediately before and after exercise is ineffective in nonhypoxic COPD patients Eur. Respir. J., October 1, 2003; 22(4): 584 - 588. [Abstract] [Full Text] [PDF]

				K. P. Hui and A. B. Hewitt A Simple Pulmonary Rehabilitation Program Improves Health Outcomes and Reduces Hospital Utilization in Patients With COPD Chest, July 1, 2003; 124(1): 94 - 97. [Abstract] [Full Text] [PDF]

				P. J. Wijkstra, Y. Lacasse, G. H. Guyatt, C. Casanova, P. C. Gay, J. Meecham Jones, and R. S. Goldstein A Meta-analysis of Nocturnal Noninvasive Positive Pressure Ventilation in Patients With Stable COPD Chest, July 1, 2003; 124(1): 337 - 343. [Abstract] [Full Text] [PDF]

				M. Ando, A. Mori, H. Esaki, T. Shiraki, H. Uemura, M. Okazawa, and H. Sakakibara The Effect of Pulmonary Rehabilitation in Patients With Post-tuberculosis Lung Disorder Chest, June 1, 2003; 123(6): 1988 - 1995. [Abstract] [Full Text] [PDF]

				P.W. Jones and R.M. Kaplan Methodological issues in evaluating measures of health as outcomes for COPD Eur. Respir. J., June 1, 2003; 21(41_suppl): 13S - 18s. [Abstract] [Full Text] [PDF]

				F. Sciurba, G. J. Criner, S. M. Lee, Z. Mohsenifar, D. Shade, W. Slivka, and R. A. Wise Six-Minute Walk Distance in Chronic Obstructive Pulmonary Disease: Reproducibility and Effect of Walking Course Layout and Length Am. J. Respir. Crit. Care Med., June 1, 2003; 167(11): 1522 - 1527. [Abstract] [Full Text] [PDF]

				National Emphysema Treatment Trial Research Group A Randomized Trial Comparing Lung-Volume-Reduction Surgery with Medical Therapy for Severe Emphysema N. Engl. J. Med., May 22, 2003; 348(21): 2059 - 2073. [Abstract] [Full Text] [PDF]

				M. Poulain, F. Durand, B. Palomba, F. Ceugniet, J. Desplan, A. Varray, and C. Prefaut 6-Minute Walk Testing Is More Sensitive Than Maximal Incremental Cycle Testing for Detecting Oxygen Desaturation in Patients With COPD Chest, May 1, 2003; 123(5): 1401 - 1407. [Abstract] [Full Text] [PDF]

				C. E. Garber and J. H. Friedman Effects of fatigue on physical activity and function in patients with Parkinson's disease Neurology, April 8, 2003; 60(7): 1119 - 1124. [Abstract] [Full Text] [PDF]