Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial

Abstract

Clinical trials identifierNCT02329873BackgroundAcute exacerbation (AE) of COPD is characterized by a sudden worsening of COPD symptoms. Previous studies have explored the effectiveness of respiratory rehabilitation for patients with COPD; however, no training program specific to acute exacerbation in elderly patients or unstable periods during hospitalization has been developed.ObjectiveTo evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration among hospitalized elderly patients with AECOPD.MethodsA randomized control trial was conducted. Pretest and posttest evaluations of 61 elderly inpatients with AECOPD (experimental group n=30; control group n=31) were performed. The experimental group received respiratory rehabilitation exercise training twice a day, 10–30 minutes per session for 4 days. The clinical parameters (dyspnea, cough, exercise tolerance, and sputum expectoration) were assessed at the baseline and at the end of the fourth day.ResultsAll participants (median age =70 years, male =60.70%, and peak expiratory flow 140 L) completed the study. In the patients of the experimental group, dyspnea and cough decreased and exercise tolerance and sputum expectoration increased significantly compared with those of the patients in the control group (all P<0.05). Within-group comparisons revealed that the dyspnea, cough, and exercise tolerance significantly improved in the experimental group by the end of the fourth day (all P<0.05).ConclusionResults of this study suggest that the respiratory rehabilitation exercise training package reduced symptoms and enhanced the effectiveness of the care of elderly inpatients with AECOPD.

Physical therapy in chronic obstructive pulmonary disease (analysis of the evidence-based medicine)

“…All studies found that pulmonary rehabilitation programs or individual physical therapy programs were effective in improving the quality of life [12][13][14][15][16][17], physical endurance [12][13][14][15][16][18][19][20][21][22][23], respiratory muscle strength [13,18,23], reducing symptoms of CoPd [14,16,19,23], improving the function of external breathing [16,[24][25][26], blood parameters [22,27], cognitive functions [21], functional state of muscles [28], survival rates [29,30], and reducing the number of hospital days [31]. The main part of investigations was devoted to the comparison of therapeutic rehabilitation programs that included several components and referred to stable patients with CoPd.…”

“…The main part of investigations was devoted to the comparison of therapeutic rehabilitation programs that included several components and referred to stable patients with CoPd. only a few studies considered the effects of individual interventions of the physical therapy arsenal [20-22, 24, 27] and the effectiveness of pulmonary rehabilitation in a hospital environment at CoPd exacerbation [17,19,31,32] ( Table 2). …”

“…The longest of the research programs was a 12-month program with recommended self lessons 5 times a day [26]. The effectiveness of a 4-day therapeutic program under stationary conditions was investigated in patients with CoPd exacerbation [19]. it is proved that even a short-term application of physical therapy in combination with smoking cessation contributes to the reduction of CoPd symptoms and increases the efficacy of managing elderly patients with exacerbation.…”