A controlled study of community-based exercise training in patients with moderate COPD

Shefalee Amin, Marlon Abrazado, Molly Quinn, Thomas W Storer, Chi-Hong Tseng, Christopher B Cooper, Shefalee Amin, Marlon Abrazado, Molly Quinn, Thomas W Storer, Chi-Hong Tseng, Christopher B Cooper

Abstract

Background: The effectiveness of clinic-based pulmonary rehabilitation in advanced COPD is well established, but few data exist for less severe patients treated in alternative settings. The purpose of this study was to investigate whether a novel, community-based exercise program (CBE) was feasible and effective for patients with moderate COPD.

Methods: Nineteen patients with moderate COPD (mean FEV1 62%) and self-reported exercise impairment were randomized to 12-weeks of progressive endurance and strength training at a local health club under the guidance of a certified personal trainer, or to continuation of unsupervised habitual physical activity. Outcomes assessed at baseline and 12 weeks included session compliance, intensity adherence, treadmill endurance time, muscle strength, dyspnea, and health status.

Results: Compliance was 94% and adherence was 83%. Comparisons between CBE and control groups yielded the following mean (SEM) differences in favor of CBE: endurance time 134 (74) seconds versus -59 (49) seconds (P=0.041) and TDI 5.1 (0.8) versus -0.2 (0.5) (P<0.001). The CBE group increased muscle strength (weight lifted) by 11.8 kilograms per subject per week of training (P<0.001). SGRQ was not significantly changed.

Conclusions: We demonstrated the feasibility and effectiveness of a novel community-based exercise program involving health clubs and personal trainers for patients with moderate COPD.

Trial registration: ClinicalTrials.gov Identifier NCT01985529.

Figures

Figure 1
Figure 1
Study design showing time frame and procedures at each visit.
Figure 2
Figure 2
Mean treadmill endurance times for the two groups at baseline and after 12 weeks. Mean changes were a decrease of 59 seconds for the control group compared with an increase of 134 seconds for those completing the community-based exercise program (P = 0.041).
Figure 3
Figure 3
Changes in total weight lifted for individual subjects from baseline to completion of training. Total weight lifted per week is calculated as the product of load (kilograms) × repetitions × sets for two days in week one and two days at end of study. Diagonal lines represent individual changes. Horizontal lines represent group means and error bars are SEM (P < 0.001).
Figure 4
Figure 4
Mean SGRQ scores for the two groups at baseline and after 12 weeks. Mean changes were a decrease of 0.7 for the control group and a decrease of 4.6 for those completing the community-based exercise program (P = 0.611). Decreased scores represent improvement in quality of life where a change of 4.0 is considered clinically meaningful.
Figure 5
Figure 5
Mean TDI focal score for the two groups after 12 weeks. Mean changes were a decrease of 0.2 for the control group and an increase of 5.1 for those completing the community-based exercise program (P < 0.001). Increased scores represent improvement in dyspnea where a change of 1.0 is considered clinically meaningful.

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