Health-related quality of life, functional status, and exercise tolerance of adults with chronic obstructive pulmonary disease following three treatment situations: Exercise alone, exercise with a lecture series, and exercise with activity training.

摘要

The effectiveness of activity training and lectures as adjuncts to exercise training in a pulmonary rehabilitation program was investigated. Forty-three outpatients with COPD were enrolled in this prospective study. Patients were randomized to one of three treatment groups: exercise training alone (ETA), exercise training plus activity training (ETAT), and exercise training plus a lecture series (ETLS).; Mixed linear models, with repeated measures, were used to study any differences between the three treatment groups with respect to quality of life and functional status as measured by the Chronic Respiratory Disease Questionnaire (CRQ), the Modified Version of the Pulmonary Functional Status and Dyspnea Questionnaire (PFSDQ-M), and the COPD Self-efficacy Scale (CSES). The instruments were administered at baseline, 6, 12, 18, and 24 weeks from the beginning of the rehabilitation program. Univariate analysis of covariance (ANCOVA) was used to analyze any effect of treatment group at discharge on exercise tolerance as measured by the six-minute walk test (6MWT). Four participants were also interviewed.; Total quality of life (QOL) was significantly greater in the ETAT group as compared to the ETLS group and marginally significantly greater in the ETAT group as compared to the ETA group. These additional QOL gains of the ETAT group were clinically meaningful and were maintained at 24 weeks.; The ETAT treatment effect for functional status was moderated by age. That is, the PFSDQ-M subscales and total scores at twelve weeks were greater in older participants in the ETAT group as compared to the two comparison treatment groups. The treatment groups did not differ significantly relative to exercise tolerance or self-efficacy.; The results of this study support the continued provision of the activity training adjunct at the cooperating facility but not the lecture series adjunct. The addition of practice and training in controlled breathing and the doing of purposeful, physical activity (in ETAT) were found to be more effective in increasing functional status and quality of life as compared to the addition of didactic instruction (in ETLS). Further research of the effectiveness of activity training as an adjunct therapy to standard exercise training for individuals with COPD is needed.