[Home-based versus ambulatory hospital-based training in COPD]. / Enfermedad pulmonar obstructiva crónica. Entrenamiento domiciliario versus ambulatorio hospitalario.

There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St.George's), submaximal (6 minutes' walk, resistance-shuttle and cycle-ergometer endurance time limit, (Tlim), and - maximal exercise tests (shuttle -ST- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70% of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125% (p = 0.0001) for rH group and 63% (p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77%, p = 0.0421 in rH and 79 %, p = 0.0197 in rD group) and in 6 minutes' test (12% in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32% abandoned in rD vs. 20% in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.

Enfermedad pulmonar obstructiva crónica entrenamiento domiciliario versus ambulatorio hospitalario

Existe poca experiencia sobre el efecto del entrenamiento domiciliario (rD) en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). El objetivo de este trabajo fue comparar el efecto del rD sobre la tolerancia al ejercicio, disnea y calidad de vida versus el entrenamiento ambulatorio hospitalario (rH). Se compararon dos grupos de pacientes con EPOC. Ambos entrenaron durante 24 sesiones, 8 semanas. Antes y después del entrenamiento se realizaron: espirometría, cuestionarios de disnea (MRC, Mahler y Borg) y calidad de vida (St. George y SF-36), pruebas de ejercicio submáximas (caminata 6 minutos, shuttle de resistencia y resistencia en cicloergómetro -tiempo límite-Tlim) y máximas (shutlle test-ST- y cardiopulmonar). El grupo rH realizó ejercicios aeróbicos y de fuerza para miembros inferiores (MI) y superiores (MS). El grupo rD realizó caminatas al 70% de la velocidad alcanzada en ST y ejercicios de fuerza para MI y MS. Se aleatorizaron 25 rH y 25 rD. La condición basal fue similar en ambos grupos. El Tlim aumentó 125% (p = 0.0001) para grupo rH y 63% (p = 0.0011) para rD, sin diferencias entre sí. También mejoraron distancia en shuttle resistencia (77%, p = 0.0421 en grupo rH y 79%, p = 0.0197 en rD) y distancia en prueba 6 minutos (12% en rD, p = 0.0135). El puntaje en cuestionario St. George se redujo solo en el grupo rH (p = 0.0034); en el rD abandonaron 32% vs. 20% en el rH (p = 0.4521). El entrenamiento domiciliario resultó tan eficaz como el ambulatorio hospitalario en pacientes con EPOC, aunque con mayor tendencia al abandono.

There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St.George´s), submaximal (6 minutes’ walk, resistance-shuttle and cycle-ergometer endurance time limit, (Tlim), and - maximal exercise tests (shuttle -ST- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70% of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125% (p = 0.0001) for rH group and 63% (p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77%, p = 0.0421 in rH and 79 %, p = 0.0197 in rD group) and in 6 minutes´ test (12% in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32% abandoned in rD vs. 20% in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.

Enfermedad pulmonar obstructiva crónica entrenamiento domiciliario versus ambulatorio hospitalario

Existe poca experiencia sobre el efecto del entrenamiento domiciliario (rD) en pacientes con enfermedad pulmonar obstructiva crónica (EPOC). El objetivo de este trabajo fue comparar el efecto del rD sobre la tolerancia al ejercicio, disnea y calidad de vida versus el entrenamiento ambulatorio hospitalario (rH). Se compararon dos grupos de pacientes con EPOC. Ambos entrenaron durante 24 sesiones, 8 semanas. Antes y después del entrenamiento se realizaron: espirometría, cuestionarios de disnea (MRC, Mahler y Borg) y calidad de vida (St. George y SF-36), pruebas de ejercicio submáximas (caminata 6 minutos, shuttle de resistencia y resistencia en cicloergómetro -tiempo límite-Tlim) y máximas (shutlle test-ST- y cardiopulmonar). El grupo rH realizó ejercicios aeróbicos y de fuerza para miembros inferiores (MI) y superiores (MS). El grupo rD realizó caminatas al 70% de la velocidad alcanzada en ST y ejercicios de fuerza para MI y MS. Se aleatorizaron 25 rH y 25 rD. La condición basal fue similar en ambos grupos. El Tlim aumentó 125% (p = 0.0001) para grupo rH y 63% (p = 0.0011) para rD, sin diferencias entre sí. También mejoraron distancia en shuttle resistencia (77%, p = 0.0421 en grupo rH y 79%, p = 0.0197 en rD) y distancia en prueba 6 minutos (12% en rD, p = 0.0135). El puntaje en cuestionario St. George se redujo solo en el grupo rH (p = 0.0034); en el rD abandonaron 32% vs. 20% en el rH (p = 0.4521). El entrenamiento domiciliario resultó tan eficaz como el ambulatorio hospitalario en pacientes con EPOC, aunque con mayor tendencia al abandono.(AU)

There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St.George´s), submaximal (6 minutes’ walk, resistance-shuttle and cycle-ergometer endurance time limit, (Tlim), and - maximal exercise tests (shuttle -ST- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70% of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125% (p = 0.0001) for rH group and 63% (p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77%, p = 0.0421 in rH and 79 %, p = 0.0197 in rD group) and in 6 minutes´ test (12% in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32% abandoned in rD vs. 20% in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.(AU)

Enfermedad pulmonar obstructiva crónica. Entrenamiento domiciliario versus ambulatorio hospitalario. / [Home-based versus ambulatory hospital-based training in COPD].

There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St.Georges), submaximal (6 minutes walk, resistance-shuttle and cycle-ergometer endurance time limit, (Tlim), and - maximal exercise tests (shuttle -ST- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70

of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125

(p = 0.0001) for rH group and 63

(p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77

, p = 0.0421 in rH and 79

, p = 0.0197 in rD group) and in 6 minutes test (12

in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32

abandoned in rD vs. 20

in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.