PURPOSE: Aerobic exercise and strength training have been shown to improve exercise tolerance, quality of life and health status in patients with chronic obstructive pulmonary disease (COPD). However, few studies have examined their safety and efficacy in groups who are of advanced age (≥80 years old), specifically.
METHODS: Data from 62 subjects (42 female/20 male; mean age 83.7±2.9 years) were chosen from a sample of 755 patients referred to the Pulmonary Wellness and Rehabilitation Center in New York City between August 1999 and December 2005. All subjects underwent pre-program and post-program evaluation including initial examination and symptom-limited exercise testing using an in-house treadmill walking protocol. During treadmill evaluation, heart rate and rhythm, blood pressure and oxygen saturation were measured in 2-minute intervals. Rate of perceived exertion and breathlessness were recorded at peak intensity. Following evaluation, subjects underwent pulmonary physical therapy consisting of breathing retraining, monitored aerobic exercise and progressive resistance exercises two times per week for twelve weeks (24 sessions total).
RESULTS: The mean peak MET level achieved during the pre- and post-rehabilitation exercise tests was 2.39±0.9 and 4.16±1.5 METs, respectively. The difference in peak MET level pre- and post-rehabilitation was statistically significant at p<.0001. Mean peak MET level improvement from pre- to post-rehabilitation exercise test was 1.77±1.04 METs. The mean percent improvement in peak MET level following rehabilitation was 80.4±48.3%. The mean maximal heart rates during the pre- and post-rehabilitation exercise tests were 97.6±15.3 and 103.7±15.5 beats per minute, respectively. There were no documented adverse events that required emergency intervention (CPR, defibrillation, intubation, etc.) for any of the subjects.
CONCLUSION: Subjects demonstrated a marked improvement in peak exercise tolerance with no increase in the frequency or severity of adverse events. Aerobic exercise and strength training were found to be safe and effective in elderly patients with COPD.
CLINICAL IMPLICATIONS: COPD is a leading cause of mortality and morbidity, causing a heavy global health and economic burden. Further investigation is warranted in this growing patient population.
DISCLOSURE: Noah Greenspan, None.