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P96 To explore the prevalence and impact of hip and/or knee in patients presenting for pulmonary rehabilitation

Background It is widely reported that individuals with COPD frequently present with co-morbidities. Osteoarthritis is an important co-morbidity that may affect an individual’s ability to participate fully in pulmonary rehabilitation (PR). There is little data exploring the impact of osteoarthritis upon PR. Aim To explore the prevalence and impact of hip and knee pain in patients attending PR and the impact of PR, that could be either detrimental or advantageous upon joint pain. Methods Patients completed standard PR outcome measures, including the Incremental Shuttle Walking Test (ISWT), Endurance Shuttle Walk Test (ESWT) and the COPD Assessment Test (CAT). The Oxford Hip and Oxford Knee questionnaires1 2 were also completed for all 4 joints pre and post PR. These questionnaires are validated, 12-item, patient reported outcome measures with a single composite score to describe the perception and impact of joint pain, over the last 4 weeks.10 represents the most perceived pain and 48 the least perceived pain. Patients participated in a 6 week outpatient PR programme, comprising supervised exercise and group-based education. This included an individually prescribed walking programme, cycling and upper and lower-limb strength training. Patients also completed an unsupervised home-exercise programme. Results n=68 attended a PR assessment (COPD n=47, bronchiectasis n=6, asthma n=5, ILD n=7, other n=3), 55.6% male; mean age 68.7±10.2 years. At baseline, 15 patients reported knee pain, 10 reported hip pain and 17 reported both hip and knee pain (62% of patients assessed). Post PR, hip and knee pain scores improved but only improvements in right knee pain reached significance (p<0.05). The ISWT, ESWT and CAT scores also improved and exceeded the MCID pre-post PR (table 1). 12 patients did not complete PR, 5 reported comorbidities as the primary reason with 3 participants reported bilateral hip pain.Abstract P96 Table 1 Baseline and post PR outcome measures for completers Baseline Post PR p value Right hip pain 43.2 (8.9) 43.3 (9.0) 0.908 Left hip pain 39.7 (11.7) 40.7 (10.7) 0.133 Right knee pain 41.1 (10.3) 42.4 (10.1) 0.027 Left knee pain 40.9 (10.7) 41.9 (9.7) 0.090 ISWT (m) 248 (155) 315 (167) <0.001 ESWT (sec) 196 (121) 611 (373) <0.001 CAT 23.1 (6.7) 20.9 (8.6) 0.018 Conclusion A significant number of participants presented with joint pain at the time of initial assessment for PR. Overall, participants improved their exercise capacity and reduced their symptom burden from their COPD. PR was not detrimental to joint pain. Alongside increases in exercise capacity, we observed slight improvements in joint pain.