Community based physiotherapeutic exercise in COPD self-management: a randomised controlled trial

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Effing, Tanja and Zielhuis, Gerhard and Kerstjens, Huib and Valk, Paul van der and Palen, Job van der (2011) Community based physiotherapeutic exercise in COPD self-management: a randomised controlled trial. Respiratory Medicine, 105 (3). pp. 418-426. ISSN 0954-6111

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Abstract:Little is known about effects of community-based physiotherapeutic exercise programmes incorporated in COPD self-management programmes. In a randomised trial, the effect of such a programme (COPE-active) on exercise capacity and various secondary outcomes including daily activity as a marker of behaviour change was evaluated.

All patients attended four 2-h self-management sessions. In addition the intervention group participated in the COPE-active programme offered by physiotherapists of private practices, consisting of a 6-month “compulsory” period (3 sessions/week) and subsequently a 5-month “optional” period (2 sessions/week). Because COPE-active was intended to change behaviour with regard to exercise, one session/week in both periods consisted of unsupervised home-based exercise training.

Of 153 patients, 74 intervention and 68 control patients completed the one-year follow-up. Statistically significant between-group differences in incremental shuttle walk test-distance (35.1 m; 95% CI (8.4; 61.8)) and daily activity (1190 steps/day; 95% CI (256; 2125)) were found in favour of the intervention group. Over the 12-month period a significant difference of the chronic respiratory questionnaire (CRQ) dyspnoea-score (0.33 points; 95% CI (0.01; 0.64)) and a non-significant difference of the endurance shuttle walk test (135 m (95% CI (−29; 298)) was found. No differences were found in the other CRQ-components, anxiety and depression scores and percentage of fat free mass.

This study demonstrates that a community-based reactivation programme improves exercise capacity in patients with moderately to severe COPD. Even more important, the programme improves actual daily activity after one-year which indicates behaviour change with regard to daily exercise.
Item Type:Article
Copyright:© 2011 Elsevier
Faculty:
Behavioural Sciences (BS)
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Link to this item:http://purl.utwente.nl/publications/80042
Official URL:http://dx.doi.org/10.1016/j.rmed.2010.09.017
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