Background and objective: Telerehabilitation has the potential to increase access to pulmonary rehabilitation (PR) for patients with COPD who have difficulty accessing centre-based PR due to poor mobility, lack of transport and cost of travel. We aimed to determine the effect of supervised, home-based, real-time videoconferencing telerehabilitation on exercise capacity, self-efficacy, health-related quality of life (HRQoL) and physical activity in patients with COPD compared with usual care without exercise training. Methods: Patients with COPD were randomized to either a supervised home-based telerehabilitation group (TG) that received exercise training three times a week for 8 weeks or a control group (CG) that received usual care without exercise training. Outcomes were measured at baseline and following the intervention. Results: Thirty-six out of 37 participants (mean AE SD age = 74 AE 8 years, forced expiratory volume in 1 s (FEV 1 ) = 64 AE 21% predicted) completed the study. Compared with the CG, the TG showed a statistically significant increase in endurance shuttle walk test time (mean difference = 340 s (95% CI: 153-526, P < 0.001)), an increase in self-efficacy (mean difference = 8 points (95% CI: 2-14, P < 0.007)), a trend towards a statistically significant increase in the Chronic Respiratory Disease Questionnaire total score (mean difference = 8 points (95% CI: −1 to 16, P = 0.07)) and no difference in physical activity (mean difference = 475 steps per day (95% CI: −200 to 1151, P = 0.16)). Conclusion: This study showed that telerehabilitation improved endurance exercise capacity and self-efficacy in patients with COPD when compared with usual care.

Background and objective: The aim of the Pulmonary Rehabilitation Guidelines (Guidelines) is to provide evidence-based recommendations for the practice of pulmonary rehabilitation (PR) specific to Australian and New Zealand healthcare contexts.

Land-based exercise is often difficult for people with chronic obstructive pulmonary disease (COPD) who have coexisting obesity or musculoskeletal or neurological conditions. This randomised controlled trial aimed to determine the effectiveness of water-based exercise training in improving exercise capacity and quality of life compared to land-based exercise training and control (no exercise) in people with COPD and physical comorbidities.Participants referred to pulmonary rehabilitation were randomly allocated to a water-based exercise, land-based exercise or the control group. The two exercise groups trained for 8 weeks, completing three sessions per week.45 out of 53 participants (mean¡SD age 72¡9 years; forced expiratory volume in 1 s 59¡15% predicted) completed the study. Compared to controls, water-based exercise training significantly increased 6-min walking distance, incremental and endurance shuttle walk distances, and improved Chronic Respiratory Disease Questionnaire (CRDQ) dyspnoea and fatigue. Compared to land-based exercise training, water-based exercise training significantly increased incremental shuttle walk distance (mean difference 39 m, 95% CI 5-72 m), endurance shuttle walk distance (mean difference 228 m, 95% CI 19-438 m) and improved CRDQ fatigue.Water-based exercise training was significantly more effective than land-based exercise training and control in increasing peak and endurance exercise capacity and improving aspects of quality of life in people with COPD and physical comorbidities.

The aim of this study was to determine if weekly, supervised, outpatient-based exercise plus unsupervised home exercise following an 8-week pulmonary rehabilitation programme would maintain functional exercise capacity and quality of life at 12 months better than standard care of unsupervised home exercise training.Chronic obstructive pulmonary disease (COPD) subjects completed an 8-week pulmonary rehabilitation programme, were randomised to an intervention group (IG) of weekly, supervised, exercise plus home exercise or to a control group (CG) of unsupervised home exercise and followed for 12 months. Outcome measurements at baseline (after pulmonary rehabilitation), and 3, 6 and 12 months included the 6-min walk test and St George's Respiratory Questionnaire (SGRQ).59 subjects with moderate COPD (Global Initiative for Chronic Obstructive Lung Disease stage II) were recruited and 48 subjects completed the study. 12-month mean difference showed no significant change from baseline in 6-min walk distance (IG -11 m, 95% CI -21-10 m; CG -6 m, 95% CI -34-11 m) or total SGRQ score (IG 3, 95% CI -0.8-7; CG -3, 95% CI -7-3).12 months following pulmonary rehabilitation both weekly, supervised, outpatient-based exercise plus unsupervised home exercise and standard care of unsupervised home exercise successfully maintained 6-min walk distance and quality of life in subjects with moderate COPD.

This study was designed to determine the effect of ground-based walking training on healthrelated quality of life and exercise capacity in people with chronic obstructive pulmonary disease (COPD).People with COPD were randomised to either a walking group that received supervised, ground-based walking training two to three times a week for 8-10 weeks, or a control group that received usual medical care and did not participate in exercise training.130 out of 143 participants (mean¡SD age 69¡8 years, forced expiratory volume in 1 s 43¡15% predicted) completed the study. Compared to the control group, the walking group demonstrated greater improvements in the St George's Respiratory Questionnaire total score (mean difference -6 points (95% CI -10--2), p,0.003), Chronic Respiratory Disease Questionnaire total score (mean difference 7 points (95% CI 2-11), p,0.01) and endurance shuttle walk test time (mean difference 208 s (95% CI 104-313), p,0.001).This study shows that ground-based walking training is an effective training modality that improves quality of life and endurance exercise capacity in people with COPD. @ERSpublications Walking training improves quality of life and endurance exercise capacity compared to usual medical care in COPD

The aims of the study were to determine the effect of short-form Sun-style t'ai chi (SSTC) (part A) and investigate exercise intensity of SSTC (part B) in people with chronic obstructive pulmonary disease (COPD).Part A: after confirmation of eligibility, participants were randomly allocated to either the t'ai chi group or control group (usual medical care). Participants in the t'ai chi group trained twice weekly for 12 weeks. Part B: participants who had completed training in the t'ai chi group performed a peak exercise test (incremental shuttle walk test) and SSTC while oxygen consumption (VO 2 ) was measured. Exercise intensity of SSTC was determined by the per cent of VO 2 reserve.Of 42 participants (mean¡SD forced expiratory volume in 1 s 59¡16% predicted), 38 completed part A and 15 completed part B. Compared to control, SSTC significantly increased endurance shuttle walk time (mean difference 384 s, 95% CI 186-510); reduced medial-lateral body sway in semi-tandem stand (mean difference -12.4 mm, 95% CI -21--3); and increased total score on the chronic respiratory disease questionnaire (mean difference 11 points, 95% CI 4-18). The exercise intensity of SSTC was 53¡18% of VO 2 reserve.SSTC was an effective training modality in people with COPD achieving a moderate exercise intensity which meets the training recommendations.KEYWORDS: Anxiety and depression, chronic obstructive pulmonary disease, exercise capacity, exercise physiology, health-related quality of life, rehabilitation T 'ai chi, an exercise involving both upper and lower extremities, originated from China. T'ai chi is characterised by posture alignment, weight shifting and circular movements that incorporate elements of muscle endurance and strengthening, balance, relaxation and breathing control. The movements of t'ai chi are unique and are often described as slow, smooth flowing and graceful.T'ai chi has become a popular training mode in western countries and requires no exercise equipment or specific training venue and thus is easily implemented in the community. Currently, a number of t'ai chi styles are utilised, including Yang, Chen and Sun styles. Each of these styles is characterised by emphasis on slightly different forms (movements). The benefits of t'ai chi on balance, exercise capacity and muscle strength have been demonstrated in the healthy population [1,2] and people with chronic conditions, such as chronic heart disease [3] and osteoarthritis [4].In comparison with other styles of t'ai chi, shortform Sun-style t'ai chi (SSTC), also known as t'ai chi for arthritis, is a modified t'ai chi programme with 21 forms. This is one of the most common styles of t'ai chi and training courses for instructors are available worldwide. Each form can be broken down into several movements which are easy to teach and learn. Compared to some other styles of t'ai chi, SSTC involves less difficult movements, such as less deep-knee bending and single leg standing, which may make it more suitable for older people.Recent studies examining t'ai ...

Diagnosis of CF had no significant negative impact on the accuracy of the SWA estimate of EE. The SWA provided a reasonably accurate estimate of EE and step count during treadmill walking.

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