Experimental evaluation of rehabilitation in chronic obstructive pulmonary disease: Short-term effects on exercise endurance and health status.

Toshima, Michelle T.; Kaplan, Robert M.; Ries, Andrew L.

doi:10.1037/0278-6133.9.3.237

Cited by 120 publications

(60 citation statements)

References 16 publications

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“…However, the pattern of these improvements was not entirely consistent, with other studies failing to find improvements in mood (Lennox, Bedell, & Stone, 1990;Segebartt, Nieman, Pover, Arabatzis, & Johnson, 1988), life satisfaction (Blumenthal et al, 1989), or well-being (Toshima et al, 1990). Such discrepancies may well be due to elements of exercise programs, demographics, operational definitions, or a general lack of sensitivity in the measurement technologies employed to assess well-being.…”

Section: Does Physical Activity Influence Psychological Well-being?mentioning

confidence: 46%

“…Indeed, 40% of the studies comprised subjects with a mean age of over 60 years. Of the 38 studies reviewed, 33 employed noninstitutionalized adult samples; the other 5 studies were selected from clinical samples engaged in the exercise component of treatment protocols such as cardiac rehabilitation (Ewart, Taylor, Reese, & Debusk, 1983) or chronic obstructive pulmonary disease (Toshima, Kaplan, & Ries, 1990).…”

Section: Subject Characteristicsmentioning

confidence: 99%

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Physical Activity, Aging, and Psychological Well-Being

McAuley¹,

Rudolph²

1995

Journal of Aging and Physical Activity

248

140

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This review examines the effects of exercise and physical activity on the psychological well-being of older adults. Unlike most of the literature in this area, this review focuses primarily on those psychosocial outcomes that are generally positive in nature. As well as considering the overall effects of physical activity, the roles of program length, subject sex, age, physical fitness, and measurement are considered. Overall, the results of the 38 studies reviewed are overwhelmingly positive, with the majority reporting positive associations between physical activity and psychological well-being. This relationship appears to be moderated by the length of the exercise programs; longer programs consistently report more positive results. There is little evidence that exercise has differential psychological effects on men and women or on individuals of differing ages. Whereas training protocols seem to result in significant changes in physical fitness and well-being, such improvements appear to be unrelated. The review concludes with a brief discussion of possible mechanisms underlying the physical activity/psychological health relationship, and several directions are recommended for future research.

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Section: Does Physical Activity Influence Psychological Well-being?mentioning

confidence: 46%

Section: Subject Characteristicsmentioning

confidence: 99%

Physical Activity, Aging, and Psychological Well-Being

McAuley¹,

Rudolph²

1995

Journal of Aging and Physical Activity

248

140

View full text Add to dashboard Cite

show abstract

“…However, since no placebocontrolled studies were available, the effective part of the programme was unknown. TOSHIMA et al [18] and more recently, RIES et al [11], showed that a rehabilitation programme, including exercise training, resulted in significantly larger improvements in exercise capacity, symptoms and quality of life than an educational programme alone ( fig. 1).…”

Section: Is Exercise Training Important In Rehabilitation Of Copd Patmentioning

confidence: 99%

Exercise training in COPD patients: the basic questions

Gosselink¹,

Troosters²,

Decramer³

1997

Eur Respir J

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Pulmonary rehabilitation programmes aim at improving exercise capacity, activities of daily living, quality of life and perhaps survival in patients with chronic obstructive pulmonary disease (COPD). Recently, well-designed studies investigated and confirmed the efficacy of comprehensive pulmonary rehabilitation programmes, including exercise training, breathing exercises, optimal medical treatment, psychosocial support and health education. In the present overview, the contribution of exercise training in clinical practice to the demonstrated effects of pulmonary rehabilitation is discussed by means of six basic questions. These include: 1) the significance of exercise training; 2) the optimal intensity for exercise training; 3) prescribing training modalities; 4) the effects of exercise training combined with medication, nutrition or oxygen; 5) how training effects should be maintained; and 6) where the rehabilitation programme should be performed: in-patient, out-patient or homecare? First, exercise training has been proven to be an essential component of pulmonary rehabilitation. Training intensity is of key importance. High-intensity training (>70% maximal workload) is feasible even in patients with more advanced COPD. In addition, the effects on peripheral muscle function and ventilatory adaptations are superior to low-intensity training. There is, however, no consensus on the optimal training modalities. Both walking and cycling improved exercise performance. Since peripheral muscle function has been recognized as an important contributor to exercise performance, specific peripheral muscle training recently gained interest. Improved submaximal exercise performance and increased quality of life were found after muscle training. The optimal training regimen (strength or endurance) and the muscle groups to be trained, remain to be determined. Training of respiratory muscles is recommended in patients with ventilatory limitation during exercise. The additional effects of anabolic-androgenic drugs, oxygen and nutrition are not well-established in COPD patients and need further research. In order to maintain training effects, close attention of the rehabilitation team is required. The continuous training frequency necessary to maintain training effects remains to be defined. At this point in time, out-patient-based programmes show the best results and guarantee the best supervision and a multidisciplinary approach. Future research should focus on the role of homecare programmes to maintain improvements.

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“…Indeed, the hyperventilation that induces dyspnoea during exercise [3,4], associated with low aerobic physical fitness due to extensive deconditioning, requires a specific training approach from a ventilatory and metabolic point of view. Despite the substantial training benefits observed in studies of CAL patients [5,6], very few have used the individualized concept. For the last 20 yrs, the intensity of exercise in training prescriptions has been based on criteria such as a percentage of maximal oxygen uptake [7] or maximal heart rate [8][9][10][11], or an empirical level defined by "as tolerated" or "highest level tolerated" [12,13], etc.…”

mentioning

confidence: 99%

Comparison of two training programmes in chronic airway limitation patients: standardized versus individualized protocols

Vallet¹,

Ahmaidi²,

Serres³

et al. 1997

Eur Respir J

144

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This study tested the effect of two methods of training, one individualized at the heart rate corresponding to the gas exchange threshold (GET) and the other at the heart rate corresponding to 50% of maximal heart rate reserve, on maximal and submaximal cardiorespiratory response in 24 patients with chronic airway limitation (CAL).The patients were randomly assigned to either the individualized training group (IT; n=12) or the standardized training group (ST; n=12). The training programme consisted of 4 weeks of stationary bicycle exercise, 5 days·week -1 .Before reconditioning began, the target level based on heart rate was not significantly different between groups (109±4 versus 110±3 beats·min -1 , in IT and ST, respectively). Post-training, a significant increase in symptom-limited oxygen uptake (V 'O 2 ,sl) and maximal O 2 pulse was found in IT, whereas ST exhibited no significant change. In each group, GET was statistically increased in much the same way as V 'O 2 ,sl, with a higher increase in IT (p<0.01) than ST (p<0.05). Nevertheless, IT exhibited a concomitant and gradual decrease in minute ventilation (V 'E), carbon dioxide production (V 'CO 2 ), and venous lactate concentration ([La]), whereas ST presented no significant change in these parameters (intergroup p<0.01). Breathing pattern was also altered after IT, at the same metabolic level and at the same ventilation level (intergroup p<0.05). Cardiac responses were modified in the two groups. At the same metabolic level, a significantly lower cardiac frequency was found both for IT and ST (intragroup p<0.05 after training). In contrast, the increase in O 2 pulse was only significantly higher in IT after training.These data show the greater efficiency of an individualized training protocol based on determination of gas exchange threshold as compared to a standardized protocol, in improving exercise performance, when applied to a patient group. Despite an apparently similar target training level, the individualized method clearly optimized the physiological training effects in patients with chronic airway limitation and, more particularly, decreased their ventilatory requirement.

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Experimental evaluation of rehabilitation in chronic obstructive pulmonary disease: Short-term effects on exercise endurance and health status.

Cited by 120 publications

References 16 publications

Physical Activity, Aging, and Psychological Well-Being

Physical Activity, Aging, and Psychological Well-Being

Exercise training in COPD patients: the basic questions

Comparison of two training programmes in chronic airway limitation patients: standardized versus individualized protocols

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