Effectiveness of Supervised Versus Home based Physiotherapy Intervention in Patients with Chronic Obstructive Pulmonary Disease (COPD)

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is a systemic disease with multiple extra pulmonary manifestations including impeded skeletal muscle function, leading to decreased muscular strength. Peak expiratory flow rate (PEFR), pulmonary function test monitoring provide a daily objective measure of lung function. A great emphasis has been placed on health related quality of life (airway questionnaire 20) of COPD. Objective: To evaluate the effect of supervised versus home based physiotherapy intervention in stable COPD patients. Methodology: Convenient sampling was used, data were collected from chest medicine department in Shree Krishna Hospital as per the inclusion and exclusion criteria fulfilled with written consent was taken. Patient were divided in to 2 groups, supervised group and home based group (40 in each group). Baseline data were taken from each patients (symptom limited walk test, quadriceps muscle strength, peak expiratory flow rate, pulmonary function test, airway questionnaire 20). Follow up assessment was taken at the end of 4th week. Result: 80 patients were enrolled to receive home based group (n=40) or supervised group (n=40), independent T –Test and paired T-Test and BI –variant analysis done. All parameter significantly improve in supervised group (mean difference [95%CI],p<0.001),FEV1/FVC ratio ( means different [95%CI,p=0.001] than the home based exercise group. Conclusion: Study concluded that supervised physiotherapy group had statistical significant changes seen in pulmonary function, quality of life as well muscle strength and symptom limited walk test than the home base physiotherapy group in stable COPD patients.