SESSION TITLE: Quality & Clinical Improvement I
SESSION TYPE: Original Investigation Slide
PRESENTED ON: Sunday, October 26, 2014 at 04:30 PM - 05:30 PM
PURPOSE: The aim of our study was to analyze the effects of rehabilitation program on quality of life and physical performance (express through 6MWD value - distance walking in 6 minutes) and pulmonary function in patients with mild and moderate COPD. All patients performed an 8 week pulmonary rehabilitation program (monitoring pharmacotherapy, education, exercise and respiratory muscle training).
METHODS: 23 subjects with COPD with FEV1± 50% were assigned to a clinic treatment group (n=13; 10 males, 3 females; mean age [±SD] = 46±8 years) or a home exercise group (n=10, 8 males, 2 females; mean age [±SD] = 48±7 years). Subjects in the clinic treatment group received supervised exercise and a home exercise program over a 8-week period. Subjects in the home exercise group received the same home exercise program initially, reinforced at a clinic visit 2 weeks later. Measured outcomes were the distance walked in 6 minutes (6MWD), the generic QoL scale Chronic Respiratory Questionnaire (CRQ). Differences parameter values between groups were tested by ANOVA test.
RESULTS: Both groups showed clinically and statistically significant improvements in 6-minute walk distances and CRQ scores at 8 weeks; improvements were still evident in both groups at 3 month. By 8 weeks, CRQ scores had improved by 43% in the clinic treatment group and by 21% in the home exercise group. 6 MWD had improved in both groups, with 12% and 9,86%. Important differences were observed in the mean changes of 6MWD at 8 weeks: 47,28m in the first group, 36,42m in the second group. At 3 months, both groups were substantially and about equally improved over baseline measurements. Subjects in the clinic treatment group were more satisfied with the overall outcome of their rehabilitative treatment compared with subjects in the home exercise group.
CONCLUSIONS: Although both groups improved by 8 weeks, subjects in the clinic treatment group achieved about twice as much improvement in 6MWD values and CRQ scores than subjects who performed similar unsupervised exercises at home. Compared with MID values for 6MWD in COPD founded in literature, our values of 6MWD changes are higher. The exact values of MID for 6MWD in mild and moderate COPD and the importance of this parameter in the management of exercise performance requires further studies.
CLINICAL IMPLICATIONS: The results indicate that a home exercise program for patients with COPD provides important benefit, but the rehabilitation programs must be supervised in the beginning.
DISCLOSURE: The following authors have nothing to disclose: Mara Popescu-Hagen, Rodica Traistaru, Constantin Marica, Otilia Rogoveanu, Mihaela Tanasescu, Paraschiva Postolache
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