Results of a home-based training program for patients with COPD.

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 FEV(1), 41.7 +/- 15.6% of predicted); and 17 patients (56.6%) from the control group (mean age, 63.1 +/- 6.9 years; mean FEV(1), 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.

[1]  P. Young,et al.  Respiratory rehabilitation in chronic obstructive pulmonary disease: predictors of nonadherence. , 1999, The European respiratory journal.

[2]  P. Jones,et al.  Randomized controlled trial of pulmonary rehabilitation in severe chronic obstructive pulmonary disease patients, stratified with the MRC dyspnoea scale. , 1998, The European respiratory journal.

[3]  Javier Toral,et al.  Eficacia de un programa de deshabituación al tabaco con tratamiento sustitutivo combinado de nicotina (parches más chicles) a los 6 meses de seguimiento , 1998 .

[4]  B. Tiep Disease management of COPD with pulmonary rehabilitation. , 1997, Chest.

[5]  T. M. Rubio,et al.  Comparación de un test de paseo de carga progresiva (shuttle walking test) con una prueba de esfuerzo en cicloergómetro en pacientes con EPOC , 1997 .

[6]  Alison E. Ries Pulmonary rehabilitation: joint ACCP/AACVPR evidence-based guidelines. ACCP/AACVPR Pulmonary Rehabilitation Guidelines Panel. American College of Chest Physicians. American Association of Cardiovascular and Pulmonary Rehabilitation. , 1997, Chest.

[7]  G. Guyatt,et al.  Economic analysis of respiratory rehabilitation. , 1997, Chest.

[8]  M. Wittmann [Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease]. , 1997, Pneumologie.

[9]  T. M. Rubio,et al.  Reproducibilidad de un test de paseo de carga progresiva (shuttle walking test) en pacientes con enfermedad pulmonar obstructiva crónica , 1997 .

[10]  F. Maltais,et al.  Intensity of training and physiologic adaptation in patients with chronic obstructive pulmonary disease. , 1997, American journal of respiratory and critical care medicine.

[11]  H. Kemper,et al.  The effects of a community-based pulmonary rehabilitation programme on exercise tolerance and quality of life: a randomized controlled trial. , 1997, The European respiratory journal.

[12]  J. Myers,et al.  Peripheral Muscle Weakness Contributes to Exercise Limitation in COPD , 1996 .

[13]  Gordon H Guyatt,et al.  Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease , 1996, The Lancet.

[14]  F. Maltais,et al.  Skeletal muscle adaptation to endurance training in patients with chronic obstructive pulmonary disease. , 1996, American journal of respiratory and critical care medicine.

[15]  T. W. van der Mark,et al.  Long-term effects of home rehabilitation on physical performance in chronic obstructive pulmonary disease. , 1996, American journal of respiratory and critical care medicine.

[16]  M. Decramer,et al.  Peripheral muscle weakness contributes to exercise limitation in COPD. , 1996, American journal of respiratory and critical care medicine.

[17]  D. Postma,et al.  A comparison between an outpatient hospital-based pulmonary rehabilitation program and a home-care pulmonary rehabilitation program in patients with COPD. A follow-up of 18 months. , 1996, Chest.

[18]  N. Jones,et al.  Muscle strength, symptom intensity, and exercise capacity in patients with cardiorespiratory disorders. , 1995, American journal of respiratory and critical care medicine.

[19]  D. O’Donnell,et al.  The impact of exercise reconditioning on breathlessness in severe chronic airflow limitation. , 1995, American journal of respiratory and critical care medicine.

[20]  J C Yernault,et al.  Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Society Task Force. , 1995, The European respiratory journal.

[21]  D. Postma,et al.  Long term benefits of rehabilitation at home on quality of life and exercise tolerance in patients with chronic obstructive pulmonary disease. , 1995, Thorax.

[22]  P. Casañ,et al.  Traducción española y validación de un cuestionario de calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica , 1995 .

[23]  D. Postma,et al.  Quality of Life in Patients With Chronic Obstructive Pulmonary Disease Improves After Rehabilitation at Home , 1995 .

[24]  A. Fishman Pulmonary rehabilitation research. , 1994, American journal of respiratory and critical care medicine.

[25]  R. Casaburi,et al.  Principles and Practice of Pulmonary Rehabilitation , 1993 .

[26]  M. S. Singh,et al.  Development of a shuttle walking test of disability in patients with chronic airways obstruction. , 1992, Thorax.

[27]  M. Belman,et al.  Reductions in exercise lactic acidosis and ventilation as a result of exercise training in patients with obstructive lung disease. , 1991, The American review of respiratory disease.

[28]  A. Ries Position Paper of the American Association of Cardiovascular and Pulmonary Rehabilitation Scientific Basis of Pulmonary Rehabilitation , 1990 .

[29]  C. Zwillich,et al.  Dyspnea in the patient with chronic obstructive pulmonary disease. Etiology and management. , 1990, Clinics in chest medicine.

[30]  G. Guyatt,et al.  Measurement of health status. Ascertaining the minimal clinically important difference. , 1989, Controlled clinical trials.

[31]  G. Guyatt,et al.  A measure of quality of life for clinical trials in chronic lung disease. , 1987, Thorax.

[32]  Belman Mj Exercise in chronic obstructive pulmonary disease. , 1986, Clinics in chest medicine.

[33]  M. Belman Exercise in chronic obstructive pulmonary disease. , 1986, Clinics in chest medicine.

[34]  M. Altose,et al.  Assessment and management of breathlessness. , 1985, Chest.

[35]  C. Wells,et al.  The measurement of dyspnea. Contents, interobserver agreement, and physiologic correlates of two new clinical indexes. , 1984, Chest.

[36]  Steyer Bj,et al.  Exercise training in chronic obstructive lung disease. , 1984, Arizona medicine.

[37]  B. Steyer Exercise training in chronic obstructive lung disease. , 1984, Arizona medicine.

[38]  D. Sinclair,et al.  Controlled trial of supervised exercise training in chronic bronchitis. , 1980, British medical journal.

[39]  S. P. Gupta,et al.  Physical rehabilitation for the chronic bronchitic: results of a controlled trial of exercises in the home. , 1977, Thorax.

[40]  W. vanEimeren Measurement of health , 1977 .

[41]  T. M. Rubio,et al.  Valores gasometricos normales en nuestro laboratorio. Su relacion con otros parametros de la exploracion funcional respiratoria , 1976 .

[42]  S. Aḥituv,et al.  The Measure , 1972 .

[43]  E. Phillipson,et al.  The physiologic basis of training patients with emphysema. , 1967, The American review of respiratory disease.

[44]  R. Sutherland The Television Debate , 1965 .

[45]  H. B. Webb The measurement of health. , 1956, A.M.A. archives of industrial health.