Effectiveness of a physical exercise training programme COPD in primary care: A randomized controlled trial

Abstract

Background: Little is known about the added value of an exercise training programme in primary care, on top of promoting physical activity, in patients with mild to moderate COPD. We evaluated the effectiveness of a Physical Exercise Training Programme COPD on exercise capacity, muscle strength, daily physical activity, breathlessness, quality of life and global perceived effect. Methods: In this RCT, 90 patients with mild to moderate COPD (FEV 1 74.2±13.5%pred) participated in a 4-month Physical Exercise Training Programme or usual care. Primary outcome was improvement in functional exercise capacity at the end of the programme, assessed by the six-minute walk test. Secondary outcomes were muscle strength, objective daily physical activity, breathlessness, health-related quality of life and global perceived effectiveness of the treatment. Results: In the primary outcome, there was a statistically and clinically relevant between-group difference of 26.6 m (p=0.020) in favour of the intervention group. For the secondary outcome measures, at 4 months, there was a significant between-group difference in shoulder abduction strength 23.9 Nm (p=0.035) and at 6 months for handgrip force 1.9 KgF (p=0.028) and CRQ mastery sub score 0.5 (p=0.035) in favour of the intervention group. Nearly all daily physical activity variables showed a positive trend at 6 months compared to baseline, but the between-group differences did not reach statistical significance. Conclusions: A Physical Exercise Training Programme in primary care improves exercise capacity in patients with mild to moderate COPD. These results indicate that there is a good evidence based basis for exercise training in primary care.