An evaluation of two approaches to exercise conditioning in pulmonary rehabilitation.
OBJECTIVE
To compare the effectiveness of two forms of exercise training in pulmonary rehabilitation.


METHODS
A prospective, randomized, unblinded, 8-week trial.


METHODS
A hospital-based outpatient pulmonary rehabilitation program.


METHODS
Forty patients (20 patients in each group) with COPD who were referred for pulmonary rehabilitation.


METHODS
We compared the short-term effectiveness of a high-intensity, lower-extremity endurance program with a low-intensity, multicomponent calisthenics program for the rehabilitation of patients with COPD. The high-intensity group trained predominately on the stationary bicycle and treadmill, with a goal of exercising at > or = 80% of maximal level determined from incremental testing for 30 min per session. The low-intensity group performed predominately classroom exercises for approximately 30 min per session. For both groups, twice-weekly sessions were held for 8 weeks. The primary outcome measure was health status, measured using the Chronic Respiratory Disease Questionnaire. Other outcomes included peak oxygen consumption on incremental treadmill exercise testing, exertional dyspnea, treadmill endurance time, the number of sit-to-stand repetitions and arm lifts in 1 min, overall dyspnea, and questionnaire-rated functional status.


RESULTS
Both groups showed significant postrehabilitation improvement in exercise variables, exertional and overall dyspnea, functional performance, and health status. Patients in the high-intensity group showed greater increases in treadmill endurance and greater reductions in exertional dyspnea, whereas those in the low-intensity group showed greater increases in arm-endurance testing. Both groups had similar improvements in overall dyspnea, functional performance, and health status.


CONCLUSIONS
Despite differences in exercise performance, both high-intensity, lower-extremity endurance training and low-intensity calisthenics led to similar short-term improvements in questionnaire-rated dyspnea, functional performance, and health status.
Normandin
Edgar A
EA
Section of Pulmonary and Critical Care, Saint Francis Hospital and Medical Center, Hartford, CT 06105, USA.
McCusker
Corliss
C
Connors
MaryLou
M
Vale
Frederick
F
Gerardi
Daniel
D
ZuWallack
Richard L
RL
D000368:Aged; D005080:Exercise Test; D005260:Female; D005541:Forced Expiratory Volume; D006173:Gymnastics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D016896:Treatment Outcome