EFFECT OF HOME-BASED EXERCISE PROGRAM ON FUNCTIONAL CAPACITY AND QUALITY OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE

K.C. Bairapareddy¹, P. Patil², A. G Maiya³

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of morbidity and mortality worldwide with significant economic and social burden. The prolonged medication and the disease itself is known to cause peripheral muscle dysfunction, reduced functional capacity and poor health-related quality of life (HRQoL). The home based exercise prescription is an effective alternative for supervised exercise based outpatient pulmonary rehabilitation (PR), especially in developing countries due to lack of resources. However, there is dearth of literature on the effect of home based exercise program in COPD.

Purpose: It is not known whether home-based exercise prescription for patients with COPD is effective for COPD patients after discharge from the hospital. The objectives of the study is to determine the effect of home-based exercise program on six-minute walk distance and HRQoL in stable COPD patients.

Methods: A total of 79 stable COPD patients (only 2 females) were randomly allocated to Home-based exercise group with mean age of 60.78± 7.88 and the control group with mean age of 61± 11.23. The patients with major comorbidity affecting the functional capacity and those who underwent PR previously were excluded from the study.  The pulmonary function test values were assessed using standard spirometry, functional capacity was assessed by six minute test, muscle strength was assessed using dynamometry  and St George Respiratory Questionnaire (SGRQ-C) was used to assess hRQoL. The intervention group was given walking at an intensity of 11-13 on Borg's rate of perceived exertion scale and a distance of 150% of Six minute walk distance covered during the test initially, and later progressed to gradually during eight weeks of the study duration. The therabands were used for resistance training for the major muscle groups in upper limb and lower limb. The standard medical intervention, prescription of breathing strategies, coughing techniques and dyspnea relieving techniques were prescribed for both intervention and control groups. The control group did not receive the home based walking program and theraband exercises. The data was analysed using Statistical Package for the Social Sciences (SPSS) version 20. Mann Whitney U test was used to compare the SGRQ scores and independent T test was used to compare the six minute walk distance and dynamometry values between the two groups. 

Results: The baseline characteristics were comparable between the two groups. There was a significant improvement in six minute walk distance in intervention group (73.28  ± 23.17) compared to control group (26.07  ± 41.93) after 8 weeks of study duration. The SGRQ values also significantly changed in SGRQ-C values in intervention group (3.87 (3.38,5.22)) compared to the control group (1.24 (-1.49-2.45)), also the dynamometry values significantly improved in intervention group compared to control group after 8 weeks of study duration (p < 0.05).  

Conclusion(s): The home based exercise program is effective in improving the functional capacity, muscle strength and Health-related quality of life in stable COPD patients.

Implications: The home based walking exercise program prescribed based on six minute walk test result and muscle strengthening with therabands may be safely applied for stable COPD patients.

Funding, acknowledgements: No external funding was received for this research project

Keywords: Home based exercise, COPD, Quality of life

Topic: Cardiorespiratory

Did this work require ethics approval? Yes

Institution: Manipal University

Committee: Kasturba Hospital, Manipal

Ethics number: UEC/ 2016/