Chaicharn Pothirat1, Warawut Chaiwong1, Nittaya Phetsuk1. 1. Division of Pulmonary, Critical Care and Allergy, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Abstract
BACKGROUND: Exercise training is an important part of pulmonary rehabilitation; however it may not be appropriate for large-scale practice in community hospitals due to the complexity of the program and expensive training equipment, including cycle ergometry and treadmills. This study therefore aims to evaluate the efficacy of a more simplified exercise training program with inexpensive training equipment. METHODS: A multicentre study of a mild to moderate intensity exercise training program was conducted based on incremental strength and endurance with two 35-40-minute sessions per week for 8 weeks. The program was performed by 30 outpatients from five community hospitals. Patients were monitored regularly for various parameters including strength of trained muscles, level of dyspnea, 6-minute walk distance, and quality of life (QoL) at baseline at 1, 2, 3, 6, 9 and 12 months. Unpaired t-tests were applied to determine the progress of trained muscle strength and minimal clinically important differences (MCIDs) were used to assess clinical outcomes. RESULTS: Thirty patients (13 males, 17 females) were enrolled with a mean age of 69.1±8.9 years, body mass index 20.5±4.4 kg/m(2), and mean % of predicted forced expiratory volume in the first second (FEV1) 45.1±10.8. According to GOLD classification, eight (26.7%) cases were in stage II, 20 (66.7%) cases in stage III, and two (6.6%) cases in stage IV. Limb and chest wall muscle strength, dyspnea level, exercise capacity and QoL showed statistically significant improvements throughout the 12-month follow-up (P<0.01). There were clinically significant improvements in QoL throughout the 12-month follow-up, exercise capacity from months 2 to 12, and dyspnea levels at months 2, 3 and 9. CONCLUSIONS: The implementation of a simplified and inexpensive exercise training program was shown to be effective for advanced chronic obstructive pulmonary disease patients in community hospitals.
BACKGROUND: Exercise training is an important part of pulmonary rehabilitation; however it may not be appropriate for large-scale practice in community hospitals due to the complexity of the program and expensive training equipment, including cycle ergometry and treadmills. This study therefore aims to evaluate the efficacy of a more simplified exercise training program with inexpensive training equipment. METHODS: A multicentre study of a mild to moderate intensity exercise training program was conducted based on incremental strength and endurance with two 35-40-minute sessions per week for 8 weeks. The program was performed by 30 outpatients from five community hospitals. Patients were monitored regularly for various parameters including strength of trained muscles, level of dyspnea, 6-minute walk distance, and quality of life (QoL) at baseline at 1, 2, 3, 6, 9 and 12 months. Unpaired t-tests were applied to determine the progress of trained muscle strength and minimal clinically important differences (MCIDs) were used to assess clinical outcomes. RESULTS: Thirty patients (13 males, 17 females) were enrolled with a mean age of 69.1±8.9 years, body mass index 20.5±4.4 kg/m(2), and mean % of predicted forced expiratory volume in the first second (FEV1) 45.1±10.8. According to GOLD classification, eight (26.7%) cases were in stage II, 20 (66.7%) cases in stage III, and two (6.6%) cases in stage IV. Limb and chest wall muscle strength, dyspnea level, exercise capacity and QoL showed statistically significant improvements throughout the 12-month follow-up (P<0.01). There were clinically significant improvements in QoL throughout the 12-month follow-up, exercise capacity from months 2 to 12, and dyspnea levels at months 2, 3 and 9. CONCLUSIONS: The implementation of a simplified and inexpensive exercise training program was shown to be effective for advanced chronic obstructive pulmonary diseasepatients in community hospitals.
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