A randomised controlled trial of the effectiveness of an exercise training program in patients recovering from severe acute respiratory syndrome

Herman Mun-Cheung Lau, Gabriel Yin-Fat Ng, Alice Yee-Men Jones, Edwin Wai-Chee Lee, Eddy Hon-Kit Siu, David Shu-Cheong Hui, Herman Mun-Cheung Lau, Gabriel Yin-Fat Ng, Alice Yee-Men Jones, Edwin Wai-Chee Lee, Eddy Hon-Kit Siu, David Shu-Cheong Hui

Abstract

The aim of this study was to evaluate the effectiveness of an exercise training program on cardiorespiratory and musculoskeletal performance and health-related quality of life of patients who were recovering from severe acute respiratory syndrome (SARS). A 6-week supervised exercise training program was carried out in the physiotherapy department of a university teaching hospital. One hundred and thirty-three patients referred from a SARS Review Clinic solely for physiotherapy were included. Cardiorespiratory fitness (6-minute walk test, Chester Step Test for predicting VO(2max)), musculoskeletal performance (isometric deltoid and gluteal muscles strength, handgrip strength, 1-minute curl-up and push-up tests) and health-related quality of life (SF-36) were measured and evaluated. Patients were assigned randomly to either a control group (standardised educational session about exercise rehabilitation) or an exercise group. After 6 weeks, significantly greater improvement was shown in the exercise group in the 6-minute walk test (77.4 m vs 20.7 m, p < 0.001), VO(2max) (3.6 ml/kg/min vs 1 ml/kg/min, p = 0.04), and musculoskeletal performance (handgrip strength, curl-up and push-up tests, p < 0.05). Effects on health-related quality of life were not statistically significant. It was concluded that the exercise training program was effective in improving both the cardiorespiratory and musculoskeletal fitness in patients recovering from SARS. However, health-related quality of life was not affected by physical training.

References

    1. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories American Thoracic Society Statement: Guidelines for the six-minute walk test. American Journal of Respiratory and Critical Care Medicine. 2002;166:111–117.
    1. Berry M.J., Rejeski W.J., Adair N.E., Zaccaro D. Exercise rehabilitation and chronic obstructive pulmonary disease stage. American Journal of Respiratory and Critical Care Medicine. 1999;160:1248–1253.
    1. Berry M.J., Rejeski W.J., Adair N.E., Ettinger W.H., Jr, Zaccaro D.J., Sevick M.A. A randomized, controlled trial comparing long-term and short-term exercise in patients with chronic obstructive pulmonary disease. Journal of Cardiopulmonary Rehabilitation. 2003;23:60–68.
    1. Bohannon R.W. Reference values for extremity muscle strength obtained by hand-held dynamometry from adults aged 20 to 79 years. Archives of Physical Medicine and Rehabilitation. 1997;78:26–32.
    1. Coordinating Committee for Physiotherapy, Hospital Authority (2003): Normative data of 6-minute walk test. Hong Kong Special Administrative Region, Hospital Authority.
    1. Decramer M., de Bock V., Dom R. Functional and histologic picture of steroid-induced myopathy in chronic obstructive pulmonary disease. American Journal of Respiratory and Critical Care Medicine. 1996;153:1958–1964.
    1. Donnelly C.A., Ghani A.C., Leung G.M., Hedley A.J., Fraser C., Riley S., Abu-Raddad L.J., Ho L.M., Thach T.Q., Chau P., Chan K.P., Lam T.H., Tse L.Y., Tsang T., Liu S.H., Kong J.H., Lau E.M., Ferguson N.M., Anderson R.M. Epidemiological determinants of spread of causal agent of severe acute respiratory syndrome in Hong Kong. Lancet. 2003;361:1761–1766.
    1. Donner C.F., Howard P. Pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) with recommendations for its use. Report of the European Respiratory Society Rehabilitation and Chronic Care Scientific Group. European Respiratory Journal. 1992;5:266–275.
    1. Gauchard G.C., Tessier A., Jeandel C., Perrin P.P. Improved muscle strength and power in elderly exercising regularly. International Journal of Sports Medicine. 2003;24:71–74.
    1. Graves J.E., Pollock M.L., Bryant C.X. 3rd ed. William and Wilkins; Baltimore: 1998. Assessment of Muscular Strength and Endurance. ACSM Resource Manual Guidelines for Exercise Testing and Prescription. 363–367.
    1. Herridge M.S., Cheung A.M., Tansey C.M., Matte-Martyn A., Diaz-Granados N., Al-Saidi F., Cooper A.B., Guest C.B., Mazer C.D., Mehta S., Stewart T.E., Barr A., Cook D., Slutsky A.S. One-year outcomes in survivors of the acute respiratory distress syndrome. New England Journal of Medicine. 2003;348:683–693.
    1. Heyward V.H. 4th ed. Human Kinetics; Champaign: 2002. Advanced Fitness Assessment and Exercise Prescription. 113–134.
    1. Jensen C.V. A computer program for randomization of patients with near-even distribution of important parameters. Computers and Biomedical Research. 1991;24:429–434.
    1. Lam C.L., Gandek B., Ren X.S., Chan M.S. Tests of scaling assumptions and construct validity of the Chinese (HK) version of the SF-36 health survey. Journal of Clinical Epidemiology. 1998;51:1139–1147.
    1. Lam C.L., Lauder I.J., Lam T.P., Gandek B. Population based norming of the Chinese (HK) version of the SF-36 health survey. The Hong Kong Practitioner. 1999;21:460–470.
    1. Lau M.C., Lee W.C., Wong N.C., Ng Y.F., Jones Y.M., Hui S.C. The impact of severe acute respiratory syndrome on the physical profile and quality of life. Archives of Physical Medicine and Rehabilitation. 2005;86:1134–1140.
    1. Lee N., Hui D., Wu A., Chan P., Cameron P., Joynt G.M., Ahuja A., Yung M.Y., Leung C.B., To K.F., Lui S.F., Szeto C.C., Chung S., Sung J.J. A major outbreak of severe acute respiratory syndrome in Hong Kong. New England Journal of Medicine. 2003;348:1986–1994.
    1. Nakago K., Senda M., Touno M., Takahara Y., Inoue H. Influence of exercise on muscle fibers in rats with steroid myopathy. Acta Medicine Okayama. 1999;53:265–270.
    1. Neff T.A., Stocker R., Frey H.R., Stein S., Russi E.W. Long-term assessment of lung function in survivors of severe ARDS. Chest. 2003;123:845–853.
    1. Peolsson A., Hedlund R., Oberg B. Intra- and inter-tester reliability and reference values for hand strength. Journal of Rehabilitation Medicine. 2001;33:36–41.
    1. Rothenhausler H.B., Ehrentraut S., Stoll C., Schelling G., Kapfhammer H.P. The relationship between cognitive performance and employment and health status in long-term survivors of the acute respiratory distress syndrome: Results of an exploratory study. General Hospital Psychiatry. 2001;23:90–96.
    1. Schelling G., Stoll C., Vogelmeier C., Hummel T., Behr J., Kapfhammer H.P., Rothenhausler H.B., Haller M., Durst K., Krauseneck T., Briegel J. Pulmonary function and health-related quality of life in a sample of long-term survivors of the acute respiratory distress syndrome. Intensive Care Medicine. 2000;26:1304–1311.
    1. Sciurba F., Criner G.J., Lee S.M., Mohsenifar Z., Shade D., Slivka W., Wise R.A. Six-minute walk distance in chronic obstructive pulmonary disease: Reproducibility and effect of walking course layout and length. American Journal of Respiratory Critical Care Medicine. 2003;167:1522–1527.
    1. Sykes K. ASSIST Creative Resources Ltd; Liverpool: 1998. The Chester Step Test: ASSIST Physiological Measurement Resources Manual Version 3.
    1. Tsang K.W., Ho P.L., Ooi G.C., Yee W.K., Wang T., Chan-Yeung M., Lam W.K., Seto W.H., Yam L.Y., Cheung T.M., Wong P.C., Lam B., Ip M.S., Chan J., Yuen K.Y., Lai K.N. A cluster of cases of severe acute respiratory syndrome in Hong Kong. New England Journal of Medicine. 2003;348:1977–1985.
    1. Walther M., Werner A., Stahlschmidt T., Woelfel R., Gohlke F. The subacromial impingement syndrome of the shoulder treated by conventional physiotherapy, self-training, and a shoulder brace: Results of a prospective, randomized study. Journal of Shoulder and Elbow Surgery. 2004;13:417–423.
    1. Ware J.E., Snow K.K., Kosinski M., Gandek B. Quality Metric Incorporated; Lincoln: 2000. SF-36 Health Survey Manual and Interpretation Guide.
    1. Wong K.T., Antonio G.E., Hui D.S., Lee N., Yuen E.H., Wu A., Leung C.B., Rainer T.H., Cameron P., Chung S.S., Sung J.J., Ahuja A.T. Severe acute respiratory syndrome: Radiographic appearances and pattern of progression in 138 patients. Radiology. 2003;228:401–406.
    1. Yoshikawa M., Yoneda T., Takenaka H., Fukuoka A., Okamoto Y., Narita N., Nezu K. Distribution of muscle mass and maximal exercise performance in patients with COPD. Chest. 2001;119:93–98.

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