Comprehensive Rehabilitation Effect Of Pulmonary-based Qigong Exercise Online Guidance On Stable COPD Patients

Objective:A study was conducted to observe the effect of the pulmonary-based Qigong exercise on quality of life,pulmonary function,exercise capacity,dyspnea,and self-efficacy of patients with stable Chronic Obstructive Pulmonary Disease（COPD）based on online guidance.Methods:This is a single-center,randomized controlled trial.Patients with stable COPD who were admitted to the Respiratory Medicine Department of Yue-Yang Integrative Medicine Hospital,an affiliate of Shanghai University of Traditional Chinese Medicine,from November 2019 to July 2020,were selected.Subjects were randomly divided into control and intervention groups.Subjects in the control group received conventional treatment and health education.Subjects in the intervention group received pulmonary-based Qigong exercise based on online guidance in addition to the conventional treatment and health education.Pulmonary-based Qigong exercises were used as intervention for lung-related diseases.The exercise included the starting posture,the“hu”,the“si”,the“two hands push up the sky to regulate the Sanjiao,”the“draw the bow to shoot the eagle”,the“bird play”,the“cross-armed iron staff”,and the closing posture.Subjects in the intervention group trained twice a day for 35min each time,5 days a week for 12 weeks.Exercise intensity was measured on a scale of 4–6 on the Borg CR 10 scale.Pre-and post-test data were collected by the same personnel.Test metrics included quality of life,lung function,exercise capacity,dyspnea,and self-efficacy.Results:1.Basic characteristicsThirty-eight subjects were included in this study,among which 36 completed the trial with a completion rate of 94.74%.No significant differences were found in gender,age,body mass index,years of education,disease duration,and disease classification between the two groups（P>0.05）.2.Quality of lifeNo statistical difference was found in the COPD Assessment Test（CAT）scores between the two groups before and after the intervention（P>0.05）.The CAT score of the control group after the trial was significantly higher than that before the trial（P<0.05）.No statistical difference was found in the CAT scores before and after the trial in the intervention group（P>0.05）.3.Pulmonary functionNo statistical difference was found in forced expiratory volume in one second percentage of predicted（FEV₁%pred）,forced expiratory volume in one second/forced vital capacity（FEV₁/FVC）,9FVC percentage of predicted（FVC%pred）,maximal mid expiratory flow（MMEF）,residual volume（RV）,and vital capacity（VC）between the two groups before and after the trial（P>0.05）.After 12 weeks of intervention,no statistical differences were found in FEV₁%pred,FEV₁/FVC,FVC%pred,MMEF,RV,and VC compared with those before the trial in both groups（P>0.05）.4.Exercise capacity:No statistical difference was found in the time spent on the 5 Times Sit to Stand（5TSTS）between the two groups before the trial（P>0.05）.After the trial,the 5TSTS time spent in the intervention group was significantly less than that in the control group（P<0.05）.No statistical difference was found in the intra-group comparison of5TSTS time spent before and after the intervention in the control and intervention groups.No statistical difference was found in the Physical Activity Scale for the Elderly（PASE）scores between the two groups either before or after the trial（P>0.05）.No statistical difference was found in the PASE scores before and after the trial in the control group（P>0.05）.No statistical difference was found in the PASE scores before and after the trial in the intervention group（P>0.05）.5.DyspneaModified Medical Research Council Dyspnea Scale（m MRC）scores were not statistically different between the two groups before the trial（P>0.05）.No statistical difference was found in the m MRC scores between the two groups after the trial（P>0.05）.No statistical difference was found in the m MRC scores of subjects in the control group before and after the trial（P>0.05）.In the intervention group,the m MRC scores after the trial were significantly lower than the scores before the trial（P<0.05）.After the trial,there was a statistical difference in the m MRC score difference between the two groups（P<0.05）,and the intervention group was better than the control group.6.Self-efficacyBefore and after the trial,no statistical difference was found in the Self-Efficacy for Managing Chronic Disease 6-Item Scale（SES6C）scores between the two groups（P>0.05）.No statistical difference was found in the SES6C scores before and after the trial in the control group（P>0.05）.No statistical difference was found in the SES6C scores before and after the trial in the intervention group（P>0.05）.Conclusions:The 12-week online-guided Pulmonary-based Qigong exercise maintained the quality of life and lower extremity exercise capacity in patients with stable COPD and alleviated their dyspnea.However,there was no significant effect on the lung function and self-efficacy of the stable COPD patients,nor on the physical activity of the patients aged 65 years and above after the intervention.Pulmonary-based Qigong exercise online guidance is recommended as a candidate treatment in pulmonary telerehabilitation for patients with stable COPD.