Effectiveness of a community-based exercise training programme to increase physical activity level in patients with chronic obstructive pulmonary disease: A randomized controlled trial.

Abstract

The exercise training included in pulmonary rehabilitation (PR) programmes improves exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD). Nevertheless, the duration of these effects is limited, and the implementation of PR is still insufficient. Moreover, the physical activity level of COPD patients is low, and it is not modified with the classic PR programmes. The purpose of this study was to assess the effects of a community-based PR programme designed to increase physical activity in COPD patients. Stable COPD patients were assigned to either an experimental group (EG, n=17) who followed a community-based 8-week programme consisting of exercise training through walking and a plan to increase activity, using a pedometer for feedback; or a control group (n=16), who followed general recommendations to walk more every day. The following were evaluated postintervention, after 3months, and after 12months: exercise capacity (endurance shuttle test [EST]), physical activity (steps/day and modified Baecke questionnaire), quality of life (St. George's Respiratory Questionnaire [SGRQ]), dyspnoea (modified Medical Research Council scale), and exacerbations. Postintervention, the EG showed significant improvements in EST times (7.6min [4.4, 10.7]), distance (549m [282, 815]; p<0.01, both), number of steps (3,361 [1,553, 5,118]), and Baecke scores (1.6 [0.2, 3.1], p<0.01). SGRQ scores decreased (-5.4 [-8.6, -2.4], p<0.01). These results remained evident after 3 and 12months (p<0.01). There were no differences between the groups nor in the exacerbations or dyspnoea. A significant association was found between increase in physical activity level, improvement in exercise capacity, and quality of life during the period monitored. A community-based programme of exercise training through walking and increased physical activity, using pedometers as feedback, produces short- and long-term improvements in exercise capacity, physical activity level, and quality of life in COPD patients.