Effects of different physical therapy programs on perceived health status in acute exacerbation of chronic obstructive pulmonary disease patients: a randomized clinical trial

Torres‐Sánchez, Irene; Valenza, Maríe Carmen; Iranzo, Maria dels Àngels Cebrià i; López‐López, Laura; Moreno-Ramírez, M Paz; Ortíz‐Rubio, Araceli

doi:10.1080/09638288.2017.1323236

Cited by 21 publications

(51 citation statements)

References 37 publications

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“…However, lack of research data hampers progress on the specific frequency intensity of exercise, the degree of supervision, and the appropriate duration of PR exercise. Aerobic exercise is the core of lung rehabilitation, while a limited number of studies have recommended specific exercise intensities for indicating an optimal duration of PR to achieve the most promising results for patients with different severities of COPD 12,13. Although the new GOLD strategy provides the most appropriate exercise training program, it is based on the resources being available at each rehabilitation location and the patients’ specific capabilities.…”

Section: Introductionmentioning

confidence: 99%

<p>Benefits of different intensities of pulmonary rehabilitation for patients with moderate-to-severe COPD according to the GOLD stage: a prospective, multicenter, single-blinded, randomized, controlled trial</p>

He¹,

Li²,

Ren³

et al. 2019

COPD

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PurposePulmonary rehabilitation (PR) is essential to manage patients with COPD. The aim of this study was to investigate the appropriate intensity of PR exercise training for patients with moderate-to-severe COPD.Patients and methodsA prospective multicenter randomized controlled trial was conducted from January 2014 to October 2018. The subjects were randomly assigned to three groups with different intensities of PR, according to their maximum oxygen uptake percentage determined by cardiopulmonary exercise testing. After 20 weeks of exercise training, the effects of low-, moderate-, and high-intensity exercise interventions on patients were compared to determine the most appropriate PR prescription.ResultsFor patients with moderate COPD, all the measured parameters were significantly improved in the moderate- and high-intensity PR groups (P<0.01), while there was no significant difference in the frequency of acute exacerbations and the mMRC questionnaire after 20 weeks of PR exercise in the low-intensity PR group. For patients with severe COPD, all variables were also improved in the high-intensity PR group (P<0.05), while the mean differences of pre- and post-PR were lower than those in patients with moderate COPD. Moreover, the Hamilton Anxiety Scale and body mass index showed no significant difference in low-intensity PR group (P>0.05).ConclusionHigh-intensity PR exercise is helpful for patients with moderate to severe COPD. Moderate COPD patients need to receive intensive PR training; the improvement degrees from PR intervention were higher than those of the severe COPD patients. For patients with severe COPD, high-intensity PR exercise may be more beneficial if patients can tolerate it.

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Section: Introductionmentioning

confidence: 99%

<p>Benefits of different intensities of pulmonary rehabilitation for patients with moderate-to-severe COPD according to the GOLD stage: a prospective, multicenter, single-blinded, randomized, controlled trial</p>

He¹,

Li²,

Ren³

et al. 2019

COPD

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“…Furthermore, patient's knowledge was one of the outcome measures presenting larger ES, showing how empowering pulmonary rehabilitation can be during AECOPD. It has been recognised that many AECOPD occur without being Exercise and breathing techniques [48] [ 24,29,33,36,45,46,51] [ 31,42,51,53] reported to health professionals [1]. Despite the short duration of these events, they have a negative impact on patients' health status, thus highlighting the importance of educating these patients [1].…”

Section: Discussionmentioning

confidence: 99%

Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis

et al. 2020

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This systematic review aimed to systematise the different designs used to deliver pulmonary rehabilitation during acute exacerbations of COPD (AECOPD) and explore which ones are the most effective. PubMed, Scopus, Web of Science, EBSCO and Cochrane were searched. Randomised controlled trials comparing pulmonary rehabilitation or at least one of its components with usual care or comparing different components of pulmonary rehabilitation were included. Network meta-analysis was conducted in MetaXL 5.3 using a generalised pairwise modelling framework. Pooled effects compared each treatment to usual care. 42 studies were included. Most studies were conducted in an inpatient setting (57%) and started the intervention 24–48 h after hospital admission (24%). Exercise training (71%), education and psychosocial support (57%) and breathing techniques (55%) were the most used components. Studies combining exercise with breathing techniques presented the larger effects on exercise capacity (weighted mean difference (WMD) −41.06, 95% CI −131.70–49.58) and health-related quality of life (WMD 16.07, 95% CI 10.29–21.84), and breathing techniques presented the larger effects on dyspnoea (WMD 1.90, 95% CI 0.53–3.27) and length of hospitalisation (effect size =0.15, 95% CI −0.28–0.57). A few minor adverse events were found.Pulmonary rehabilitation is a safe intervention during AECOPD. Exercise, breathing techniques, and education and psychosocial support seem to be the core components for implementing pulmonary rehabilitation during AECOPD. Studies may now focus on comparisons of optimal timings to start the intervention, total duration of the intervention, duration and frequency of sessions, and intensity for exercise prescription.

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“…Of the studies included in this review, 19 (95%) were published in peer-reviewed journals [2][3][4]12,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] and 1 (5%) was a published abstract for which further information was obtained from the author 34 (see Supplemental Table S1). These 20 studies described 16 unique randomized controlled trials, [2][3][4]12,[19][20][21][22][23][24][25][26][29][30][31]34 and 2 were single-group studies. 28,33 Two studies were qualitative analyses which utilized responses from participants recruited to two of the randomized controlled trials.…”

Section: Resultsmentioning

confidence: 99%

Exercise training for adults hospitalized with an acute respiratory condition: a systematic scoping review

et al. 2019

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Objective: In adults hospitalized with an acute or chronic respiratory condition, to determine what has been reported regarding exercise programmes in terms of content, tolerability, evaluation and adverse events. Data sources: A systematic search was conducted of electronic databases (PubMed, EMBASE, CINAHL, PEDro, The Cochrane Library), trial registries and conference abstracts (Thoracic Society of Australia and New Zealand Annual Scientific Meeting, the European Respiratory Society Congress, the American Thoracic Society International Conference). Review methods: Studies were included if they (1) recruited adults hospitalized with an acute or chronic respiratory condition, (2) described an exercise programme that targeted peripheral muscles and (3) reported that ⩾80% of the sample had initiated training within 72 hours of hospitalization. Results: The last search was conducted on 2 June 2019. Of the 6282 records identified, 20 met the study criteria. These described 18 separate studies (2018 participants). Studies were conducted in adults hospitalized with an exacerbation of chronic obstructive pulmonary disease or with community-acquired pneumonia. The content of exercise programmes included aerobic and/or resistance training, neuromuscular electrical stimulation, whole-body vibration or movement out of bed. In eight studies (44%), the initial session was prescribed using objective measures of exercise capacity, peripheral muscle force and the ability to undertake activities of daily living. Across 7420 training sessions, seven adverse events were reported. Conclusion: Methods used to prescribe and titrate exercise programmes in adults hospitalized with an acute or an exacerbation of a chronic respiratory condition were disparate. When reported, programmes were well tolerated and adverse events were infrequent.

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Effects of different physical therapy programs on perceived health status in acute exacerbation of chronic obstructive pulmonary disease patients: a randomized clinical trial

Cited by 21 publications

References 37 publications

<p>Benefits of different intensities of pulmonary rehabilitation for patients with moderate-to-severe COPD according to the GOLD stage: a prospective, multicenter, single-blinded, randomized, controlled trial</p>

<p>Benefits of different intensities of pulmonary rehabilitation for patients with moderate-to-severe COPD according to the GOLD stage: a prospective, multicenter, single-blinded, randomized, controlled trial</p>

Design of pulmonary rehabilitation programmes during acute exacerbations of COPD: a systematic review and network meta-analysis

Exercise training for adults hospitalized with an acute respiratory condition: a systematic scoping review

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