Abstract
BackgroundThe effectiveness of clinic-based pulmonary rehabilitation in advanced COPD is well established, but few data exist for less severe patients treated in alternative settings. The purpose of this study was to investigate whether a novel, community-based exercise program (CBE) was feasible and effective for patients with moderate COPD.MethodsNineteen patients with moderate COPD (mean FEV1 62%) and self-reported exercise impairment were randomized to 12-weeks of progressive endurance and strength training at a local health club under the guidance of a certified personal trainer, or to continuation of unsupervised habitual physical activity. Outcomes assessed at baseline and 12 weeks included session compliance, intensity adherence, treadmill endurance time, muscle strength, dyspnea, and health status.ResultsCompliance was 94% and adherence was 83%. Comparisons between CBE and control groups yielded the following mean (SEM) differences in favor of CBE: endurance time 134 (74) seconds versus -59 (49) seconds (P = 0.041) and TDI 5.1 (0.8) versus -0.2 (0.5) (P < 0.001). The CBE group increased muscle strength (weight lifted) by 11.8 kilograms per subject per week of training (P < 0.001). SGRQ was not significantly changed.ConclusionsWe demonstrated the feasibility and effectiveness of a novel community-based exercise program involving health clubs and personal trainers for patients with moderate COPD.Trial registrationClinicalTrials.gov Identifier NCT01985529.
Highlights
The effectiveness of clinic-based pulmonary rehabilitation in advanced Chronic obstructive pulmonary disease (COPD) is well established, but few data exist for less severe patients treated in alternative settings
We have studied the feasibility of a community-based exercise program under the supervision of personal trainers appropriately certified in exercise physiology and trained to manage pulmonary patients safely and with confidence
We examined the hypothesis that in patients with moderate COPD and reduced aerobic capacity, the combination of aerobic exercise training plus nutritional counseling would result in improvement in exercise endurance, muscle strength, activity levels and quality of life compared with control group having only nutritional counseling
Summary
The effectiveness of clinic-based pulmonary rehabilitation in advanced COPD is well established, but few data exist for less severe patients treated in alternative settings. The purpose of this study was to investigate whether a novel, community-based exercise program (CBE) was feasible and effective for patients with moderate COPD. Chronic obstructive pulmonary disease (COPD) is a progressive debilitating disease that leads to worsening symptoms and declining exercise capacity [1]. Skeletal muscle dysfunction is recognized to account for an appreciable portion of the exercise impairment in COPD patients [4]. Evidence for this particular abnormality includes reduced muscle aerobic enzyme content [5,6] and a tendency to develop premature lactic acidosis during exercise [1]. One could argue that successful treatment requires earlier recognition of the decline in exercise performance and implementation of a structured exercise program to reverse its deleterious effects
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