« Clustering and predictors of response to pulmonary rehabilitation in patients with chronic obstructive pulmonary disease » ; Phénotypage et déterminants de la réponse à la réhabilitation respiratoire chez le patient atteint de la broncho-pneumopathie chronique obstructive

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death in the world. It affects 12 million French but only 1/3 receive a medical diagnosis. The initial assessment of patients is a key issue in the long-term management of COPD with the goal of improving quality of life and reducing disability.Pulmonary rehabilitation (PR) is an effective treatment for COPD, which consists of comprehensive management of the patient including exercise training, respiratory physiotherapy and patient’s therapeutic education.The 6-minute walk test (6MWT) is the universal test used to assess the patient's physical performance and is the main tool for evaluating the effect of rehabilitation. However, some non-responders according to this 6MWT criteria express an improvement of their general state according to other criteria. Indeed, this test is easy to perform but only evaluates the overall walking ability during a short test, while the success of the rehabilitation program depends on other criteria : physical (strength, balance, endurance), psychological (anxiety, depression, self-esteem, motivation) and educational (knowledge of the disease, its treatments, self-care).We propose to analyze response of COPD patients to PR in order to determine phenotypes of patients with clusters according to their responses to PR, and to identify predictors of response to PR, and for the long run, we propose an optimization of the RR according to these phenotypes. ; La broncho-pneumopathie chronique obstructive (BPCO) représente la troisième cause de décès dans le monde. Elle touche 15 millions Français mais seul 1/3 reçoivent un diagnostic médical. Le dépistage et l’évaluation initiale des patients représentent un enjeu essentiel dans la prise en charge à long terme de la BPCO dans l’objectif d’améliorer la qualité de vie et de diminuer le handicap.La réhabilitation respiratoire (RR) est un traitement efficace de la BPCO, qui consiste en une prise en charge globale du malade comportant un réentrainement à l’effort, de la ...