Chest
Volume 118, Issue 1, July 2000, Pages 106-114
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Clinical Investigations: Rehabilitation
Results of a Home-Based Training Program for Patients With COPD

https://doi.org/10.1378/chest.118.1.106Get rights and content

Objectives

To have a group of COPD patients undergo a simple program of home-based exercise training, using the shuttle walking test (SWT) to standardize the intensity of training.

Methods

Sixty patients participated, randomly distributed into two groups (rehabilitation and control) of 30 patients each. The following evaluations were carried out at baseline and at 12 weeks: (1) pulmonary function studies; (2) SWT; (3) submaximal intensity resistance test; (4) cycle ergometer test; (5) quality of life; and (6) dyspnea. The rehabilitation group underwent a lower-extremity training program. Walking was selected as the type of exercise. The intensity of training was set at 70% of the maximum speed attained on the SWT. Divided sessions were held, lasting 1 h, 6 days/wk, at home, with a checkup every 2 weeks. The duration of the program was 12 weeks.

Results

The following patients completed the study: 20 patients (66.6%) from the rehabilitation group (mean [± SD]) age, 64.3 ± 8.3 years; mean FEV1, 41.7 ± 15.6% of predicted); and 17 patients (56.6%) from the control group (mean age, 63.1 ± 6.9 years; mean FEV1, 40 ± 16.4% of predicted). We found no changes in pulmonary function or effort parameters (SWT or cycle ergometer) in the rehabilitation group at 12 weeks. A twofold increase (1,274 ± 980 to 2,651 ± 2,056 m; p < 0.001) was achieved in the submaximal intensity resistance test, with less dyspnea at the conclusion of the test (p = 0.05). Significant improvement also was achieved in basal dyspnea and, both statistically and clinically, in the quality of life. Significant changes were not achieved in the control group patients.

Conclusions

A simple home-based program of exercise training achieved improvement in exercise tolerance, posteffort dyspnea, basal dyspnea, and quality of life in COPD patients.

Section snippets

Patients

We studied 60 patients who had COPD diagnosed in accordance with the European Respiratory Society Consensus Statement,1 which defines this illness as a disorder characterized by decreased maximum expiratory flow and slow forced emptying of the lungs that is slowly progressive, irreversible, and does not change markedly over several months. All patients were in a stable phase of their disease with optimal drug management (ie, bronchodilator therapy and oxygen therapy, if necessary). The criteria

Results

Ten patients dropped out of the rehabilitation group: 6 left for lack of cooperation (20%), and 4 were excluded due to acute exacerbation of their underlying pathology. Thirteen patients dropped out the control group: 7 did not cooperate with evaluations (23%); 4 had acute exacerbations; 1 had suffered a cerebral vascular accident; and 1 was waiting for prostate cancer surgery. Twenty patients from the rehabilitation group and 17 from the control group completed the study.

Baseline pulmonary

Discussion

With our simple home-based program of standardized training for the muscles of ambulation, our group of COPD patients with moderate disease showed improvement in their tolerance of submaximal exercise, in dyspnea, and in quality of life. These results are similar to those found in the literature,7,8 although the latter were obtained through rather complex rehabilitation programs.

We did not find changes in pulmonary function or in arterial blood gas levels.13, 14, 15, 16 We also did not find

ACKNOWLEDGMENT

The authors thank Dr. Cayuela for his assistance in the statistical analyses, and Drs. Cejudo and Whaley for their assistance in the translation of the manuscript into English.

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