Chest
Clinical InvestigationsCOPDExercise Maintenance Following Pulmonary Rehabilitation: Effect of Distractive Stimuli
Section snippets
Specific Aims
We sought to determine if DAS in the form of music would facilitate adherence to a walking regimen following completion of a PRP and, thereby, augment the effectiveness of post-PRP maintenance training as indicated by perceptions of dyspnea during activities of daily living (ADL) and 6-min walk (6MW) distance.
Materials and Methods
The sample was a convenience sample of 24 patients (83% female) aged 68.1 ± 8 years (mean ± SD), defined as the first 24 subjects who met the inclusion criteria, consented to participate, and completed 8 weeks of data collection. Of these, 5 patients (16.7%) were African American and 19 patients (83.3%) were white. Six additional patients (all men) were approached but refused to participate because they did not wish to be randomized. Entry criteria were the following: (1) diagnosis of COPD (FEV1
Results
There were no significant differences at baseline in any measured variables (Table 1). When demographics were examined, control group subjects were older (p = 0.05) than DAS subjects. No between-group differences were found for marital status (p = 0.58), years of education (p = 0.07), ethnicity (p = 0.29), employment (p = 0.89), or oxygen requirement (p = 0.83).
Using multivariate analysis of variance, no significant difference was noted between groups (F = 1.277, degrees of freedom [df] = 11,
Discussion
The major findings of this study were the following: (1) subjects who used DAS (music) during post-PRP maintenance training improved functional performance reflected in an increase in 6MW distance and a decrease in perceived dyspnea compared to control subjects; and (2) depressive symptoms decreased over time in both groups. No significant differences were noted between groups, over time, or interaction of group and time for anxiety, global QoL, HRQoL (total or subscores), or symptoms during
Conclusion
PRPs significantly increase functional capacity and reduce symptoms in patients with COPD. Unfortunately, the majority of patients experience a significant loss of the training effect within 1 year following completion of a formal program. This study suggests important benefits from the use of distraction as a means to maintain functional performance. The major findings were that subjects who used DAS (music) while walking improved post-PRP 6MW distance and decreased perceptions of dyspnea
Acknowledgment
The authors thank Judith Erlen, RN, PhD, and Mildred Jones, RN, PhD, who served as members of the dissertation committee for this study; Andrew Petrini, MS, Lorraine Brock, RN, Todd Pollock, MS, B.J. Veschio, RRT, and Terry Riffer, MS, who served as case finders; and Fred Tasota, RN, MSN, for editorial assistance.
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Measuring intensity during free-living physical activities in people with chronic obstructive pulmonary disease: A systematic literature review
2022, Annals of Physical and Rehabilitation MedicineCitation Excerpt :The most frequently used outcomes, outcome measures and instruments to assess single free-living PA-related intensity were dyspnoea with the modified Borg scale; cardiac function via HR, measured with HR monitors; and pulmonary gas exchange, especially VO2, measured with portable gas analysers. In total, 32 studies referred to absolute intensity [20, 22-28, 30, 31, 33, 34, 36-38, 40-47, 49, 51, 52, 56, 57, 60-63] and 32 to relative intensity [20, 22-26, 29-36, 39, 40, 42, 46-48, 50-55, 57, 58, 60-62]. From the latest studies, 2 estimated maximum intensity using equations [47, 54].
Physical exercise in chronic diseases
2018, Nutrition and Skeletal MuscleEvaluation of Dyspnea in the Elderly
2017, Clinics in Geriatric MedicineDistractive auditory stimuli in the form of music in individuals with COPD: A systematic review
2015, ChestCitation Excerpt :Four studies applied aerobicand walking-based training,33,35,36,52 and a single study focused on upper limb (UL) training.34 One study explored effects during a single exercise session,52 and one study applied training for 1 month34; one for 2 months33; and two for 3 months,5,36 of which one incorporated longer-term training.36 The details of the exercise testing are included in Table 2.
Rhythmic auditory stimulation increases 6-Minute walk distance in individuals with COPD: A repeated measures study
2020, Heart and LungCitation Excerpt :Desensitization and distraction have been effective in reducing dyspnea and anxiety.26,31–33 For this reason, music has been used extensively as a cognitive behavioral distractive strategy to increase physical performance in chronically ill participant's distracting them from uncomfortable symptoms.7,8,34,35 Bauldoff, et al. reported that perceived dyspnea was reduced during the 6MWT coupled with an increase in walk distance in the group that received the music compared to the group that did not during a home-based walking program.7
Supported by the National Institute of Nursing Research, National Institutes of Health grant No. 1F31 NR07599.