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1 From the Department of Physiological Nursing and the Department of Medicine, University of California, San Francisco
Study objective: To determine whether exercise training with coaching is more effective than exercise training alone in reducing dyspnea and the anxiety and distress associated with it and improving exercise performance, self-efficacy for walking, and dyspnea with activities of daily living.
Design: Randomized clinical trial of 51 dyspnea-limited patients with COPD assigned to monitored (n=27) or coached (n=24) exercise groups.
Setting: Outpatient area of university teaching hospital.
Intervention: Both groups completed 12 supervised treadmill training sessions (phase 1) over 4 weeks followed by 8 weeks of home walking (phase 2). The CE group also received coaching during training.
Measurements: Perceived work of breathing, dyspnea intensity, distress associated with dyspnea, and anxiety associated with dyspnea were rated on a visual analog scale during incremental treadmill testing and after 6-min walks before and after phase 1. Dyspnea with activities of daily living, self-efficacy for walking, state anxiety, and 6-min walks were measured before and after both phases.
Results: Dyspnea and the associated distress and anxiety improved significantly for both groups relative to work performed and in relation to ventilation (p<0.05). There were no significant differences between groups in any outcomes. The phase 1 improvement in laboratory dyspnea was accompanied by improvements in dyspnea with activities of daily living (p<0.01) and self-efficacy for home walking (p<0.01) that were sustained during the home phase.
Conclusions: Coaching with exercise training was no more effective than exercise training alone in improving exercise performance, dyspnea, and the anxiety and distress associated with it, dyspnea with activities, and self-efficacy for walking.
Key Words: anxiety and distress associated with dyspnea • coaching • COPD • desensitization to dyspnea • exercise
Submitted on November 30, 1994
Accepted on July 22, 1996
This article has been cited by other articles:
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F. Gigliotti, C. Coli, R. Bianchi, I. Romagnoli, B. Lanini, B. Binazzi, and G. Scano Exercise Training Improves Exertional Dyspnea in Patients With COPD: Evidence of the Role of Mechanical Factors Chest, June 1, 2003; 123(6): 1794 - 1802. [Abstract] [Full Text] [PDF]
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 Research Priorities in Respiratory Nursing Am. J. Respir. Crit. Care Med., December 1, 1998; 158(6): 2006 - 2015. [Full Text] [PDF]
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