MedWire News: Resistance training (RT) and endurance training (ET) both sustain and improve the effects of in-patient pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD), with little difference detected between the two training methods, a Norwegian study shows.
"The choice between RT or ET, or a combination, may be guided by individual needs, patient preferences and the availability of equipment," the authors write in the journal Respiratory Medicine.
Pulmonary rehabilitation (PR) improves impairment and disability in patients with COPD. Physical training is a key aspect of PT, and is capable of generating significant improvements in health-related quality of life (HRQOL) on its own, the authors report. However, these benefits fade over time in the absence of physical activity.
PR is aimed at creating permanent changes in the behaviour of COPD patients towards increased physical activity after patients have left the rehabilitation centre. But some form of supervision after PR seems necessary if the improvements in body functions are to be sustained.
Siri Skumlien, from Sunnaas Hostpital in Nesoddtangen, and colleagues compared the effects of RT and ET on adherence to therapy, ability to further improve walking capacity, HRQOL and functional status, differences in HRQOL, and participation in physical activity 1 year after the intervention.
The team recruited 22 men and 19 women with COPD to a parallel group study. Patients were allocated to either supervised RT or ET twice a week for 12 weeks in a primary care setting after completing 4 weeks of in-patient pulmonary rehabilitation (IPR).
Walking capacity (treadmill endurance time [TET] and 6-min walking distance [6MWD]), functional status (Glittre ADL-test and Hyrim Physical Activity Questionnaire), and HRQOL (St. George's Respiratory Questionnaire [SGRQ]) were evaluated as outcome measures. HRQOL and physical activity were reinvestigated after 1 year.
The authors found that attendance rates were the same for both training methods. Both groups showed an improvement in TET (RT 7.7 min, ET 5.7 min), although 6MWD increased significantly only after ET (46 m). Functional status was unchanged. SGRQ tended to further improve after RT, whereas ET maintained the improvement gained during IPR. After 1 year, most patients in both groups were exercising regularly, but SGRQ was significantly better than pre-IPR in the RT group.
"Our study shows that primary care exercise training for 12 weeks after the completion of multidisciplinary IPR was practicable, with excellent adherence rates," the authors write.
"Both RT and ET resulted in a better walking capacity, and the gains in HRQOL and functional status from IPR were maintained."
Skumlien and colleagues conlude: "supervised RT or ET twice weekly sustains and improves the effects of multidisciplinary IPR."
Journal
