Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease

Summary

Presented here is a protocol to investigate the effects of home-based prescribed pulmonary exercise in stable chronic obstructive pulmonary disease (COPD) patients, which is modified based on traditional Chinese exercises according to dyspnea and limited exercise capacity observed in COPD patients.

Abstract

As a systemic disease, chronic obstructive pulmonary disease (COPD) affects the respiratory system, inducing restless and exercise dyspnea. It also impacts exercise capacity and forms a vicious circle in which it further aggravates the condition of patients and accelerates disease progression. As a functional holistic exercise, traditional Chinese exercises (TCE) play an important role in the rehabilitation of COPD on the basis of adjusting the breath and performing coordinated movements. This study investigates the effects of prescribed pulmonary exercises (which are modified from TCE) on exercise capacity of upper and lower limbs, endurance exercise capacity, and quality of life in stable COPD patients. The goal is to determine the accessibility of these prescribed exercises in COPD rehabilitation. Participants are randomly divided into a non-exercise control group (CG) or prescribed pulmonary exercise group (PG) at a ratio of 1: 1. The PG receives intervention for 60 min twice per day, 7 days a week, for a total of 3 months. The intensity is measured using the Borg category-ratio 10 scale and with a heart-rate monitor. Then, an exercise capacity test and quality of life questionnaire are scheduled at 1 week before and after the formal intervention. After 3 months of intervention, the 30 s arm curl test, 30 s sit-to-stand test, 6 min walking test, and quality of life show significant improvement in COPD patients (p < 0.05). These findings indicate that prescribed pulmonary exercises can be applied as alternative, convenient, and effective home- and community-based exercises for stable COPD patients.

Introduction

Chronic non-communicable diseases have gradually become the biggest threat to global health, accounting for 70% of global mortality. A majority of such deaths have been caused by four main diseases, while COPD ranks third and only falls behind cardiovascular disease and cancer. Moreover, the ranking of COPD in leading to years of life lost has risen from eleventh in 2007 to seventh in 2017¹. This change indicates unsatisfactory effects of current treatments in the rehabilitation of COPD progression. More studies have recognized that COPD is not only a respiratory disease but also a complex, multi-systemic, and multi-complicative condition

Protocol

The protocol has been approved by the Ethics Committee of Yueyang Hospital of Integrated Traditional Chinese and Western Medicine affiliated with Shanghai University of Traditional Chinese Medicine (Shanghai, China).

1. Video construction and study design

1. Construct a video of the prescribed pulmonary exercise. Our video was based on the TCE video issued by the General Administration of Sport of China.
   1. In the video, have a member of the research team in a spacious place display and give a general introduction to the different characteristics of the prescribed pulmonary exercises.
   2. Have the member simulate th....

Results

The protocol above describes a randomized controlled trial to investigate whether prescribed pulmonary exercise improves exercise capacity and quality of life in stable COPD patients. While 44 participants were recruited, only 37 (84%) participants completed the study (CG = 19, PG = 18). Thus, data analysis was carried out using the 37 participants, and the two groups showed no significant differences in basic characteristics including age, sex, BMI, duration, and disease grade (Table 1).

Discussion

In this study, a modified TCE referred to as prescribed pulmonary exercise is used in an intervention program, and a number of fitness tests are used to investigate the effects of home-based prescribed pulmonary exercise on exercise capacity and quality of life in stable COPD patients. The main finding is that many improvements occurred in upper and lower limb exercise capacity, endurance exercise capacity, and quality of life after 3 months of intervention. The results indicate that prescribed pulmonary exercise as a CO.......

Materials

Name	Company	Catalog Number	Comments
4643a	Tanita		Used for the evaluation of height, weight, and body mass index
Borg CR10	None		Used for the evaluation of dyapnea
PASS 15.0	NCSS, LLC		Used for power calculation
Polar team 2	Polar		Used for supervising the heart rate of participants
SGRQ software	Developed by Peking Union Medical College		Used for calculating the score of quality of life
SPSS 24.0	IBM Corporation		Used for statistical analysis