Effectiveness Of Home-based Prescribed Pulmonary Exercise On Patients With Stable COPD

Objective This study aimed to investigate the effects of home-based prescribed pulmonary exercise in COPD patients,and the results may provide a valid evidence for the targeted and convenience methods applied in COPD patients.Methods Stable COPD patients were recruited in the department of respiratory medicine,Yue-Yang Integrative Medicine Hospital affiliated to Shanghai University of Traditional Chinese Medicine from July 2017 to July 2018.All patients maintain their medical treatment and randomly assigned to one of two groups receiving usual care(control group,CG),pulmonary exercise prescription(PG)in 1:1 ratio.Patients in CG only received medical treatment and receive no exercise intervention.Patients in PG performed 60 min of exercise intervention twice a day,7 days a week for 3 months,of which,one day will be performed in hospital and received guidance and supervision.The main characteristics of pulmonary exercise prescription including “hu” and “si” sounding in Liuzijue,“pushing up the sky to regulate the triple warmer” and “drawing bow to shoot a vulture” in Baduanjin,“the crane actions including the crane spreading its wings and the crane flying” in Wuqinxi,and “crossarmed iron staff” in Yijinjing.Exercise intensity was supervised by the Borg CR-10(to maintain an intendency from 4 to 6),and monitored through the heart rate assessed by Polar team 2.All index including pulmonary function,skeletal muscle function,exercise capacity,quality of life and dyspnea were conducted within 1 week at baseline and at the end of 3 months.Results 1.Basic characteristics A total of 44 patients with COPD were recruited,and 37(84%)patients completed the 3 months' intervention.Of which,19 patients in CG with the ae of 64.58 ± 9.06,and the FEV1%pred was 59.16 ± 18.15.18 patients in PG with the age of 66.11 ± 9.08,and the FEV1%pred was 59.18 ± 4.34.There were no differences between the two groups at baseline(P < 0.05).2.Pulmonary function There were no differences between the two groups not only at baseline but also at the end of intervention(P < 0.05).In addition,no obvious change can be observed within the two groups after intervention(P < 0.05).3.Isokinetic muscle strength After 3 months intervention,PG showed improved elbow extensor TW,extensor and flexor PT/BW.Furthermore,the improvement of flexor PT,extensor TW,and flexor TW in PG was significantly higher than in CG(P < 0.05).After 3 months' intervention,knee flexor PT,flexor TW,and flexor ER of CG were significantly decreased,while extensor PT,extensor PT/BW,flexor PT/BW,extensor TW,and flexor TW of PG were significantly increased(P < 0.01).Considering the changes of the two groups after 3 months' intervention,extensor PT,extensor PT/BW,flexor PT/BW,extensor TW,and flexor TW of PG were significantly improved compared with CG(P < 0.01).4.Exercise capacity While 6MWD%pred showed significantly decreased in CG(P < 0.05),30 seconds arm curl test,30 s SST,6MWD,and 6MWD%pred showed increased significantly in PG(P < 0.01)after intervention.Considering the changes of the two groups,30 seconds arm curl test,30 s SST,6MWD,and 6MWD%pred of PG were significantly improved compared with CG(P < 0.01).5.Quality of life and dyspnea There were no differences between the two groups at baseline not only in quality of life but also in dyspnea.After intervention,the scores of activity of SGRQ showed increased in CG(P = 0.01),while the scores of all items of SGRQ showed decreased in PG(P < 0.01).In addition,the changes of quality of life showed significantly difference between the two groups.In dyspnea,there were no obvious changes within and between the two groups.Conclusion Home-based prescribed pulmonary exercise showed significant and positive effects on the aspect of skeletal muscle function,exercise capacity and quality of life.This study preliminarily demonstrated the feasibility and effectiveness of the homebased prescribed pulmonary exercise in the rehabilitation for patients with stable COPD,indicating that the prescribed pulmonary exercise can be applied as a rehabilitation method to COPD patients at home and in communities.