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(Chest. 2000;118:106-114.)
© 2000 American College of Chest Physicians

Results of a Home-Based Training Program for Patients With COPD*

Maria Teresa Elías Hernández, MD; Teddoro Montemayor Rubio, MD; Francisco Ortega Ruiz, MD; Hildegard Sánchez Riera, MD; Rosa Sánchez Gil, MD and Jose Castillo Gómez, MD

* From the Pneumology Department, Virgen del Rocío University Hospital, Seville, Spain.

Correspondence to: Maria Teresa Elías Hernández, MD, Avenida Las Pajanosas, No. 50, Guillena, 41210, Seville, Spain; e-mail: med009981{at}nacom.es

Objectives: To have a group of COPD patients undergo a simple program of home-based exercise training, using the shuttle walking test (SWT) to standardize the intensity of training.

Methods: Sixty patients participated, randomly distributed into two groups (rehabilitation and control) of 30 patients each. The following evaluations were carried out at baseline and at 12 weeks: (1) pulmonary function studies; (2) SWT; (3) submaximal intensity resistance test; (4) cycle ergometer test; (5) quality of life; and (6) dyspnea. The rehabilitation group underwent a lower-extremity training program. Walking was selected as the type of exercise. The intensity of training was set at 70% of the maximum speed attained on the SWT. Divided sessions were held, lasting 1 h, 6 days/wk, at home, with a checkup every 2 weeks. The duration of the program was 12 weeks.

Results: The following patients completed the study: 20 patients (66.6%) from the rehabilitation group (mean [± SD]) age, 64.3 ± 8.3 years; mean FEV1, 41.7 ± 15.6% of predicted); and 17 patients (56.6%) from the control group (mean age, 63.1 ± 6.9 years; mean FEV1, 40 ± 16.4% of predicted). We found no changes in pulmonary function or effort parameters (SWT or cycle ergometer) in the rehabilitation group at 12 weeks. A twofold increase (1,274 ± 980 to 2,651 ± 2,056 m; p < 0.001) was achieved in the submaximal intensity resistance test, with less dyspnea at the conclusion of the test (p = 0.05). Significant improvement also was achieved in basal dyspnea and, both statistically and clinically, in the quality of life. Significant changes were not achieved in the control group patients.

Conclusions: A simple home-based program of exercise training achieved improvement in exercise tolerance, posteffort dyspnea, basal dyspnea, and quality of life in COPD patients.Keys words: COPD; home-based training program; rehabilitation; shuttle walking test




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