Impact of Lower-Limb Endurance Training on Dyspnea and Lung Functions in Patients with COPD

Abstract

BACKGROUND:Patients with chronic obstructive pulmonary disease (COPD) exhibit persistent dyspnea in daily activities and irreversible airflow obstruction. These will finally lead to an inability to carry on daily activities and markedly decrease their quality of life. Endurance training was considered as therapy modality to alleviate several symptoms experienced by COPD patients.AIM:This study aims to identify the impact of lower-limb exercise on dyspnea and spirometry test results in COPD patients.METHODS:We performed a quasi-experimental study in July 2017 on 20 stable COPD patients divided both in group C and D according to GOLD 2017 criteria. Patients were given an individualised dose of stationary cycling twice a week for one month in which every session lasted 5-20 minutes gradually. Before and after rehabilitation program, pulmonary function tests were measured by spirometry to obtain per cent predicted of Forced Expiratory Volume in 1 second (FEV1), Forced Volume Capacity (FVC), Peak Expiratory Flow (PEF) and Forced Expiratory Flow at 25-75% of the pulmonary volume (FEF25-75), and dyspnea was measured by the mMRC index. Statistical analysis was performed by Wilcoxon and T-dependent test.RESULTS:Baseline value of FVC (49.6 ± 21.6%) increased significantly to 59.65 ± 16.53% after one month of endurance training program (p = 0.01). Surprisingly, there was also a significant increase in FEV1 value from 46.9 ± 21.7 to 52.9 ± 20.7% (p < 0.005). The increase of FVC and FEV1 in group C was slightly higher than in group D although not statistically significant (p = 0.29; p = 0.25 respectively). However, no difference was observed in PEF and FEF25-75 value (p > 0.05). Patients’ dyspnea scale also showed significant improvement (p < 0.001) from mMRC median scale 2 (range 1-3) to 1 (range 0-2) in both groups C and D. There was no exacerbation found during rehabilitation program.CONCLUSION:Twice a week lower-limb endurance training for one-month improved dyspnea and pulmonary function test results in COPD patients safely and effectively.

Effect of muscle training on dyspnea in patients with chronic obstructive pulmonary disease

“…[ 38 ] A study showed that LL endurance training twice a week for 1 month improved dyspnea and pulmonary function test results safely and effectively in patients with COPD. [ 39 ] However, a meta-analysis confirmed that a combination of resistance and endurance trainings increases leg muscle strength, health-related quality of life, walking distance, and exercise capacity in patients with COPD, but none of the included studies investigated their combined effect on the level of dyspnea. [ 40 ] The results of LL training mainly showed its influence on muscle strength and endurance, and most studies have not reported on the effects of the training on dyspnea.…”

Pulmonary rehabilitation for patients with coronavirus disease 2019 (COVID‐19)

“…Furthermore, several high‐quality clinical studies have verified the benefits of pulmonary rehabilitation for inpatients, outpatients, and in–home patients. The benefits include improved exercise tolerance in patients with chronic pulmonary diseases, reduced number of hospital admissions and length of hospital stays, enhanced health‐related quality of life, 5 improved respiratory muscle function and relieved dyspnea, 6 alleviated disease‐related anxiety and depression, 7 and enhanced skeletal muscle function of upper and lower limbs 8 , 9 …”

Functional Status of Acute Covid-19 Patients Receiving Physiotherapy, At Discharge: A Case Series

“…Patient was able to maintain an oxygen saturation of 99% on room air by the 3 rd day of intervention. There was also an 118% increment in 30SSTS score when compared to day 1, which shows improvement in muscle endurance and exercise tolerance [16,17] following regular physiotherapy; Endurance training has shown to be a useful modality to alleviate symptoms in patients with COPD by showing improvements in dyspnoea and pulmonary function tests [18]. This 28-year-old, physically active individual admitted in the isolation facility showed excellent response to the intervention, as evident by the outcome measures ( [24] observed that healthy individuals will have a predicted 6MWD of 631 ±93meter.…”