A randomised study of the effects of supplemental exercise sessions after a 7-week chronic obstructive pulmonary disease rehabilitation program.

BACKGROUND: Several studies have suggested that the effects of chronic obstructive pulmonary disease (COPD) rehabilitation programs tend to attenuate with time. We aimed to investigate the effects of supplemental exercise sessions following an initial 7-week COPD rehabilitation program with regard to exercise capacity and disease-specific quality of life (QoL). METHODS: We performed a 7-week COPD rehabilitation program in 140 COPD patients. Patients (n = 118) who completed the initial program were randomised for additional six supervised supplemental exercise sessions or three follow-up examinations without exercise. Both groups were followed for 12 months. Primary end-points were QoL as measured by the St. George's Respiratory Questionnaire total score and exercise capacity as measured by the endurance shuttle walking time (ESWT). RESULTS: A marked increase in ESWT (from 193 to 921 s) and a moderate decrease in total SGRQ score (2.5 points) was obtained during the initial 7 weeks rehabilitation program. The ESWT declined moderately and was 645 s at week 52 in both the intervention and control group. Unexpectedly, QoL increased slightly in the control group, while it decreased slightly in the intervention group. However, there were no statistically significant differences between the groups in the observed changes in QoL or ESWT at any time point. CONCLUSIONS: In conclusion, a program of six supplemental exercise sessions following the initial 7-week COPD rehabilitation program did not have any effect on ESWT or QoL during a 1-year follow-up.

Results of an outpatient multidisciplinary COPD rehabilitation programme obtained in two settings: primary and secondary health care.

BACKGROUND AND AIMS: There is limited experience with implementation of chronic obstructive pulmonary disease (COPD) rehabilitation in primary care settings. We aimed to evaluate the implementation of a COPD rehabilitation programme in a primary care setting and compare the effects with those obtained in a secondary health-care setting. MATERIALS AND METHODS: The same outpatient multidisciplinary 7-week rehabilitation programme was implemented in a primary (day care nursery) and a secondary (hospital) health-care setting. Disease-specific quality of life (QoL) and endurance shuttle walking time (ESWT) was assessed at the start and end of the programme. Additionally, QoL was assessed again at a 3-months follow-up. RESULTS: No serious problems or adverse events were encountered during the training/rehabilitation sessions. A total of 48 patients (81.3%) and 75 patients (84.2%) completed the 7-week rehabilitation programme in the primary and secondary settings, respectively. Within both centres, we found statistically significant improvements of ESWT and total St. George's Respiratory Questionnaire score. The improvement of ESWT was significantly greater in the secondary care setting than in the primary care setting. CONCLUSIONS: we found that it was possible to implement a COPD rehabilitation programme in a Danish primary care setting. In this non-randomised study, improvements of QoL and ESWT obtained in the primary care setting were reasonably similar to those obtained in the secondary care setting.