TY - JOUR
T1 - Effectiveness of an exercise training programme COPD in primary care
T2 - A randomized controlled trial
AU - Fastenau, Annemieke
AU - Van Schayck, Onno C. P.
AU - Winkens, Bjorn
AU - Aretz, Karin
AU - Gosselink, Rik
AU - Muris, Jean W. M.
N1 - Funding Information:
Funding of this study is provided by the MUMC MOVE programme of Maastricht University and an unconditional grant from Boehringer-Ingelheim, The Netherlands .
Publisher Copyright:
© 2020
PY - 2020
Y1 - 2020
N2 - Background: Pulmonary rehabilitation is very effective in improving exercise capacity, dyspnea and quality of life in the small group of patients with moderate to severe COPD. Given that little is known about exercise training in the large group of patients with mild to moderate COPD, we assessed the effectiveness of an exercise training programme in primary care.Methods: In this RCT, 90 patients with mild to moderate COPD (FEV1 74.2 +/- 13.5%pred) participated in a 4-month exercise training programme or control treatment. Primary outcome was improvement in functional exercise capacity, assessed by the 6-min walking distance (6MWD). Secondary outcomes were breathlessness (MRC dyspnoea score), disease-specific quality of life (CCQ, CRQ), muscle strength and objective daily physical activity. There was a follow-up measurement at 6 months.Results: At 4 months, we found a statistically and clinically relevant between-group difference in 6MWD of +26.6 m (95% CI: 4,3-49.0, p = 0.020). Shoulder strength significantly improved with a between-group difference of 23.9 Nm (p = 0.0350). At 6 months, there was a significant improvement in handgrip force and CRQ sub score mastery of respectively 1.9 KgF (p = 0.028) and 0.5 (p = 0.035). There were no significant between-group differences in breathlessness, quality of life, knee strength and daily physical activity.Conclusion: The results indicate that exercise training in primary care is particularly effective in improving physical fitness (exercise capacity and strength), but not in breathlessness, health-related quality of life and daily physical activity. A broader assessment for COPD patients in primary care might be a necessary condition to offer the most effective intervention.
AB - Background: Pulmonary rehabilitation is very effective in improving exercise capacity, dyspnea and quality of life in the small group of patients with moderate to severe COPD. Given that little is known about exercise training in the large group of patients with mild to moderate COPD, we assessed the effectiveness of an exercise training programme in primary care.Methods: In this RCT, 90 patients with mild to moderate COPD (FEV1 74.2 +/- 13.5%pred) participated in a 4-month exercise training programme or control treatment. Primary outcome was improvement in functional exercise capacity, assessed by the 6-min walking distance (6MWD). Secondary outcomes were breathlessness (MRC dyspnoea score), disease-specific quality of life (CCQ, CRQ), muscle strength and objective daily physical activity. There was a follow-up measurement at 6 months.Results: At 4 months, we found a statistically and clinically relevant between-group difference in 6MWD of +26.6 m (95% CI: 4,3-49.0, p = 0.020). Shoulder strength significantly improved with a between-group difference of 23.9 Nm (p = 0.0350). At 6 months, there was a significant improvement in handgrip force and CRQ sub score mastery of respectively 1.9 KgF (p = 0.028) and 0.5 (p = 0.035). There were no significant between-group differences in breathlessness, quality of life, knee strength and daily physical activity.Conclusion: The results indicate that exercise training in primary care is particularly effective in improving physical fitness (exercise capacity and strength), but not in breathlessness, health-related quality of life and daily physical activity. A broader assessment for COPD patients in primary care might be a necessary condition to offer the most effective intervention.
KW - COPD
KW - Exercise training
KW - Physical activity
KW - Primary care
KW - Randomized controlled trial
KW - RESPIRATORY SOCIETY STATEMENT
KW - OBSTRUCTIVE PULMONARY-DISEASE
KW - QUALITY-OF-LIFE
KW - PHYSICAL-ACTIVITY
KW - MILD COPD
KW - REHABILITATION
U2 - 10.1016/j.rmed.2020.105943
DO - 10.1016/j.rmed.2020.105943
M3 - Article
C2 - 32308200
SN - 0954-6111
VL - 165
JO - Respiratory Medicine
JF - Respiratory Medicine
M1 - 105943
ER -