Abstract
Background: Hospitalisations for AECOPD impair functional capacity, muscle force and physical activity, and increase the risk of future exacerbations. Evidence supporting the benefits of exercise training in patients hospitalised with an AECOPD is limited. Objective: To determine the effects of an exercise intervention initiated within 48 hours of admission for an AECOPD on functional capacity, quadriceps muscle force (QMF) and physical activity. Methods: Thirty-eight patients (mean±SD age 64±7yr; FEV 1 33±14%pred) were randomised to either a control group (CG; n=18) or an exercise group (EG; n=20). Patients in the CG received standard usual care (e.g. airway clearance and encouragement to mobilise). In addition to standard usual care, patients in the EG performed individualised progressive walking and functional resistance exercises. Primary outcomes were two-minute walk distance (2MWD) and QMF. Secondary outcomes were Timed-Up and Go (TUG) and daily steps recorded using a Stepwatch Activity Monitor. Between group differences are expressed as mean difference; 95% CI. Results: Median [interquartile range] length of stay in the CG and EG were 7[6 to 8] and 8[6 to 9]days (p=0.64). Those in the EG completed 4±1 supervised and 4±1 unsupervised exercise sessions. Compared with changes seen in the CG group, those in the EG demonstrated greater gains in 2MWD (13; 3 to 23m) and QMF (2.8; 0.3 to 5.3kg). No between group differences were seen in average daily steps (1409; -880 to 3699 steps) or TUG (0.7; -0.6 to 2.1s). Conclusion: Early exercise minimised the deleterious effects of AECOPD on exercise capacity and QMF.
Published Version
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