{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T06:29:09Z","timestamp":1790490549511,"version":"4.1.0"},"reference-count":59,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2019,8,20]],"date-time":"2019-08-20T00:00:00Z","timestamp":1566259200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>To date, it remains unknown which patients report a clinically-relevant improvement in fatigue following pulmonary rehabilitation (PR). The purpose of this study was to identify and characterize these responders. Demographics, lung function, anxiety (anxiety subscale of the 90-item symptom checklist (SCL-90-A)), depression (Beck depression inventory for primary care (BDI-PC)), exercise tolerance (six-minute walking distance test (6MWD)), and health status (Nijmegen clinical screening instrument (NCSI)) were assessed before and after a 12-week PR programme. Fatigue was assessed using the checklist individual strength (CIS)-Fatigue. Patients with a decline \u2265 10 points (minimally clinically important difference, MCID) on the CIS-Fatigue were defined as responders. Chronic obstructive pulmonary disease (COPD) patients (n = 446, 61 \u00b1 9 years, 53% male, forced expiratory volume in 1 s (FEV1) 43% \u00b1 18% predicted, 75% severe fatigue) were included. Mean change in fatigue after PR was 10 \u00b1 12 points (p &lt; 0.01) and exceeded the MCID. In total, 56% were identified as fatigue responders. Baseline CIS-Fatigue (45 \u00b1 7 vs. 38 \u00b1 9 points, respectively, p &lt; 0.001) and health-related quality-of-life (HRQoL; p &lt; 0.001) were different between responders and non-responders. No differences were found in demographics, baseline anxiety, depression, lung function, 6MWD, and dyspnoea (p-values &gt; 0.01). Responders on fatigue reported a greater improvement in anxiety, depression, 6MWD, dyspnoea (all p-values &lt; 0.001), and most health status parameters. PR reduces fatigue in COPD. Responders on fatigue have worse fatigue and HRQoL scores at baseline, and are also likely to be responders on other outcomes of PR.<\/jats:p>","DOI":"10.3390\/jcm8081264","type":"journal-article","created":{"date-parts":[[2019,8,21]],"date-time":"2019-08-21T11:19:06Z","timestamp":1566386346000},"page":"1264","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Pulmonary Rehabilitation Reduces Subjective Fatigue in COPD: A Responder Analysis"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3333-6964","authenticated-orcid":false,"given":"Maarten","family":"Van Herck","sequence":"first","affiliation":[{"name":"REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium"},{"name":"Department of Research and Development, CIRO+, Center of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanine","family":"Antons","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Pulmonary Diseases, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan H.","family":"Vercoulen","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3453-7220","authenticated-orcid":false,"given":"Yvonne M. J.","family":"Go\u00ebrtz","sequence":"additional","affiliation":[{"name":"Department of Research and Development, CIRO+, Center of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zjala","family":"Ebadi","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Burtin","sequence":"additional","affiliation":[{"name":"REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1827-9869","authenticated-orcid":false,"given":"Daisy J. A.","family":"Janssen","sequence":"additional","affiliation":[{"name":"Department of Research and Development, CIRO+, Center of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands"},{"name":"Centre of Expertise for Palliative Care, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa S. Y.","family":"Thong","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline","family":"Otker","sequence":"additional","affiliation":[{"name":"Member of Lung Foundation Netherlands, 3818 LE Amersfoort, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold","family":"Coors","sequence":"additional","affiliation":[{"name":"Member of Patient Advisory Board, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam A. G.","family":"Sprangers","sequence":"additional","affiliation":[{"name":"Department of Medical Psychology, Amsterdam University Medical Centers, Location AMC, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8780-476X","authenticated-orcid":false,"given":"Jean W. M.","family":"Muris","sequence":"additional","affiliation":[{"name":"Department of General Practice, CAPHRI Research Institute, 6229 HX Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith B.","family":"Prins","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3822-7430","authenticated-orcid":false,"given":"Martijn A.","family":"Spruit","sequence":"additional","affiliation":[{"name":"REVAL Rehabilitation Research Center, BIOMED Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium"},{"name":"Department of Research and Development, CIRO+, Center of Expertise for Chronic Organ Failure, 6085 NM Horn, The Netherlands"},{"name":"Department of Respiratory Medicine, Maastricht University Medical Center, 6229 HX Maastricht, The Netherlands"},{"name":"NUTRIM School of Nutrition and Translational Research in Metabolism, 6229 ER Maastricht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeannette B.","family":"Peters","sequence":"additional","affiliation":[{"name":"Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, 6525 GA Nijmegen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,8,20]]},"reference":[{"key":"ref_1","unstructured":"Global Initiative for Chronic Obstructive Lung Disease (2018, November 07). 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