Attenuation of Dyspnea and Improved Quality-of-Life through Exercise Training in Patients with COPD

摘要

Carter R, Tiep B, Koh Y. Attenuation of Dyspnea and Improved Quality-of-Life through Exercise Training in Patients with COPD. JEPonline 2016;19(1):1-16. This study evaluated changes in dyspnea and health-related quality of life (HRQOL) before and after exercise training in a COPD cohort. One hundred and twenty-six patients with moderate to severe COPD (%PredFEV1 = 45.9 ±12.5%) were evaluated before and after 16 wks of exercise training (ET). Patient assessments included: pulmonary function tests; gas exchange; cycle ergometry (CE); arm ergometry (AE); and the 6-min walk test (6MWT) with dyspnea measured using Borg scores and with the multidimensional Chronic Respiratory Disease Questionnaire (CRQ). Following ET, work performance was significantly increased for CE, AE, and the 6MWT (P<.0001) and these changes were considered clinically significant. Borg scores at peak exercise decreased for CE (–0.95 ± 2.8 units, P<.003); AE (-0.8 ± 2.6 units, P<.02), and 6MWT (-0.5 ± 2.3 units, P<.05) with greater work output. Borg scores for CE and AE at isotime demonstrated significant improvement (CE – 1.4 ± 2.0, P<.0001). Statistically significant and clinically relevant improvements in CRQ dyspnea (7.00 ± 5.76 (P<.0001)); emotional function (4.5 ± 6.3, P<.0001); fatigue (4.1 ± 4.1 P<.0001); mastery 3.1 ± 3.5, P<.0001), and total CRQ score (20.0 ± 15.9, P<.0001) were observed. The data suggest that a 13- watt or 12-watt or greater increase for CE and AE, respectively, represents clinically significant improvements. Exercise training improves upper and lower extremity work performance and reduces dyspnea during exercise while improving overall quality-of-life.