Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 9 » Issue 1

Chronic disease self-management and exercise in COPD as pulmonary rehabilitation: a randomized controlled trial

Authors Cameron-Tucker HL, Wood-Baker R, Owen C, Joseph L, Walters EH

Received 29 November 2013

Accepted for publication 3 February 2014

Published 19 May 2014 Volume 2014:9(1) Pages 513—523

DOI https://doi.org/10.2147/COPD.S58478

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Helen L Cameron-Tucker,1 Richard Wood-Baker,1 Christine Owen,2 Lyn Joseph,3 E Haydn Walters1

1Centre of Research Excellence for Chronic Respiratory Disease and Lung Aging, School of Medicine, University of Tasmania, Hobart, TAS, Australia; 2Faculty of Education, University of Tasmania, Hobart, TAS, Australia; 3Department of Respiratory Medicine, Royal Hobart Hospital, Hobart, TAS, Australia

Purpose: Both exercise and self-management are advocated in pulmonary rehabilitation for people with chronic obstructive pulmonary disease (COPD). The widely used 6-week, group-based Chronic Disease Self-Management Program (CDSMP) increases self-reported exercise, despite supervised exercise not being a program component. This has been little explored in COPD. Whether adding supervised exercise to the CDSMP would add benefit is unknown. We investigated the CDSMP in COPD, with and without a formal supervised exercise component, to address this question.
Patients and methods: Adult outpatients with COPD were randomized to the CDSMP with or without one hour of weekly supervised exercise over 6 weeks. The primary outcome measure was 6-minute walk test distance (6MWD). Secondary outcomes included self-reported exercise, exercise stage of change, exercise self-efficacy, breathlessness, quality of life, and self-management behaviors. Within- and between-group differences were analyzed on an intention-to-treat basis.
Results: Of 84 subjects recruited, 15 withdrew. 6MWD increased similarly in both groups: CDSMP-plus-exercise (intervention group) by 18.6±46.2 m; CDSMP-alone (control group) by 20.0±46.2 m. There was no significant difference for any secondary outcome.
Conclusion: The CDSMP produced à small statistically significant increase in 6MWD. The addition of a single supervised exercise session did not further increase exercise capacity. Our findings confirm the efficacy of a behaviorally based intervention in COPD, but this would seem to be less than expected from conventional exercise-based pulmonary rehabilitation, raising the question of how, if at all, the small gains observed in this study may be augmented.

Keywords: supervised exercise, physical capacity, 6-minute walk distance

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]

 

Readers of this article also read:

A telehealth program for self-management of COPD exacerbations and promotion of an active lifestyle: a pilot randomized controlled trial

Tabak M, Brusse-Keizer M, van der Valk P, Hermens H, Vollenbroek-Hutten M

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:935-944

Published Date: 9 September 2014

Central airways remodeling in COPD patients

Pini L, Pinelli V, Modina D, Bezzi M, Tiberio L, Tantucci C

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:927-933

Published Date: 1 September 2014

Characteristics and self-rated health of overlap syndrome

Chung JW, Kong KA, Lee JH, Lee SJ, Ryu YJ, Chang JH

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:795-804

Published Date: 21 July 2014

Adjunctive treatment with oral AKL1, a botanical nutraceutical, in chronic obstructive pulmonary disease

Brockwell C, Ampikaipakan S, Sexton DW, Price D, Freeman D, Thomas M, Ali M, Wilson AM

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:715-721

Published Date: 9 July 2014

Pathogenesis of hyperinflation in chronic obstructive pulmonary disease

Gagnon P, Guenette JA, Langer D, Laviolette L, Mainguy V, Maltais F, Ribeiro F, Saey D

International Journal of Chronic Obstructive Pulmonary Disease 2014, 9:187-201

Published Date: 15 February 2014