Abstract
Resting hypoxemia is the most severe stage of Chronic Obstructive Pulmonary Disease (COPD). Due to their impairments during the exacerbation, these patients are limited to traditional exercise rehabilitation and are excluded from the majority of the studies. The aim of this study was to assess the feasibility and the efficacy of two exercise programs in Acute Exacerbation of COPD (AECOPD) patients with resting hypoxemia. In this randomized clinical trial, patients hospitalized due to an acute exacerbation of COPD with hypoxemia at rest were included. Patients were randomly assigned into three groups. A Control Group (pharmacological treatment), a Global Exercise Group (GEG), and a Functional Electrostimulation Group (FEG). Patients were treated during the hospitalization period. The main outcomes were lower limb strength (assessed by a dynamometer), balance (assessed by the one leg standing balance test), health related quality of life (assessed by the EQ-5D), adverse events and adherence. At the end of the intervention, there were significant differences in all the variables in favour of the experimental groups (p < 0.05). We concluded that conducting an exercise program is feasible and improves lower limb strength, balance, and health related quality of life in AECOPD patients with resting hypoxemia.
Highlights
Accepted: 17 August 2021The prevalence of hypoxia in patients with Chronic Obstructive Pulmonary Disease (EPOC) increase as the disease worsens [1], due to the progressive airflow limitation and emphysematous destruction of the pulmonary capillary bed [2]
Different types of hypoxemia have been described in Chronic Obstructive Pulmonary Disease (COPD) patients, resting hypoxemia being the most severe stage of the disease [3]
Hypoxia is considered an important factor in many of the comorbidities that characterize COPD, such as myocardial stress due to the increased heart rate, musculoskeletal dysfunction, and systemic inflammation [4]. These comorbidities are worsened during an exacerbation [5] due to prolonged bed rest and treatment with steroids [6], showing a reduction in the quality of life, exercise tolerance, and a greater risk of death in these patients [7]
Summary
Accepted: 17 August 2021The prevalence of hypoxia in patients with Chronic Obstructive Pulmonary Disease (EPOC) increase as the disease worsens [1], due to the progressive airflow limitation and emphysematous destruction of the pulmonary capillary bed [2]. Hypoxia is considered an important factor in many of the comorbidities that characterize COPD, such as myocardial stress due to the increased heart rate, musculoskeletal dysfunction, and systemic inflammation [4]. These comorbidities are worsened during an exacerbation [5] due to prolonged bed rest and treatment with steroids [6], showing a reduction in the quality of life, exercise tolerance, and a greater risk of death in these patients [7]. Individual exercise training is an integral component of respiratory rehabilitation [9], there is controversy over the safety and possible adverse effects in these patients
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