IJCRR - Vol 06 Issue 13, July, 2014
A STUDY OF SHORT TERM PULMONARY REHABILITATION ON EXERCISE CAPACITY, FORCED VITAL CAPACITY AND QUALITY OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Author: Christian Preeti S.
Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive disease characterized by airflow limitation / obstruction that is either not reversible or only partially reversible. Pulmonary rehabilitation is an accepted non-pharmacological intervention for individuals with COPD. But there is ‘no consensus’ regarding the most favorable duration of pulmonary rehabilitation for patients with COPD. Objective: To determine the effects of a short term Pulmonary Rehabilitation programme on exercise capacity, forced vital capacity and Quality of life in chronic obstructive pulmonary disease. Methods: 30 mild-moderate COPD patients, who fulfill inclusion and exclusion criteria, were given conventional physical therapy and aerobic training for 5 days per week and continued for 4 weeks. 6 min walk distance; Forced vital capacity (FVC) and chronic respiratory questionnaire (CRQs) were taken at baseline before and after completion of rehabilitation program as outcome measures. Results: Results show statistically significant difference in 6 min walk distance (6 MWD), Dyspnea, Fatigue (p<0.05). But no significant difference was found in FVC, Emotion and Mastery Conclusion: Through the study it has been observed that 6 MWD and CRQs shows more improvement whereas FVC shows no much improvement after 4 week of rehabilitation program. Hence it has been concluded that short term pulmonary rehabilitation is an effective and economical method for improving the exercise capacity and Quality of life but not similarly effective for FVC in patients with COPD.
Keywords: Chronic Obstructive Pulmonary Disease, Pulmonary Rehabilitation, Chronic Respiratory Disease Questionnaire, Forced Vital Capacity, 6 Minute Walk Test.
Christian Preeti S.. A STUDY OF SHORT TERM PULMONARY REHABILITATION ON EXERCISE CAPACITY, FORCED VITAL CAPACITY AND QUALITY OF LIFE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE International Journal of Current Research and Review. Vol 06 Issue 13, July, 15-23
1. American Thoracic Society. Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease. Am J RespirCrit Care Med 1995; 152:77-121.
2. British Thoracic Society. Guidelines for the management of chronic obstructive pulmonary disease. Thorax 1997; 52: 1-28.
3. Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis management and prevention of chronic obstructive lung disease. NIH Publication2001;2701:1-100.
4. Siafakas NM, Vermeire P, Pride NB. Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European RespiratorForce. EurRespir J 1995; 8: 1398-1420.
5. Guidelines for Management of Chronic Obstructive Pulmonary Disease (COPD) in India: A Guide for Physicians.Indian J Chest Dis Allied Sci 2004; 46: 137-153.
6. K.J.R. Murthy, J.G. Sastry. Economic burden of chronic obstructive pulmonary disease. Burden of Disease in India 2012;234-275.
7. Votto J, Bowen J, Scalise P. Short stay comprehensive inpatient pulmonary rehabilitation for advanced chronic obstructive pulmonary disease. Arch Phys Med Rehabil 1996; 77:1115-1118.
8. Von Leupoldt A, Hahn E, Taube K, Schubert Heukeshoven S, Magnussen H, Dahme B.Effects of 3-week outpatients pulmonary rehabilitation on exercise capacity, dyspnea, and quality of life in COPD. Lung 2008; 186(6):387-91.
9. Skumlien S, Skogedal EA, Bjortuft O. Four weeks intensive rehabilitation generates significant health effects in COPD patients. Chronic Respiratory Disease 2007; 2:5-13.
10. Elpern EH, Stevens D, Kesten S. Variability in performance of timed walk tests in pulmonary rehabilitation programs. Chest 2000; 118: 98–105.
11. Carolyn L. Rochester, MD. Exercise training in chronic obstructive pulmonary disease. Journal of Rehabilitation Research and Development 2003; 40(5):5980.
12. Nobuaki Miyahara,Ryosuke EDA,hiroyasutakeyama,Naomi kunichika,michihikomoriyama,keisukeaoe et al.Effect of short term pulmonary rehabilitation on exercise capacity and quality of life in participant with chronic obstructive pulmonary disease.Acta Med Okayama 2000;54(4):179-184
13. Pitta F, Troosters T, Probst VS. Are patients with COPD more active after pulmonary rehabilitation? Chest 2008; 134(2): 273-280
14. EinarHaave, Michael E Hyland, HaraldEngvik. Improvements in exercise capacity during a 4-weeks pulmonary rehabilitation program for COPD patients do not correspond with improvements in selfreported health status or quality of life. International Journal of COPD 2007;2(3): 355–359
15. Brenda O’Neill, Anne Marie,McKevitt, Sara Rafferty, Judy M Bradley,Doreen Johnston et al. A Comparison of Twice- Versus OnceWeekly Supervision during Pulmonary Rehabilitation in Chronic Obstructive Pulmonary Disease. Chest 2002; 121:1085- 1091.
16. Hatem FS Al Ameri. Six minute walk test in respiratory diseases: A university hospital experience.Thoracic medicine 10.4103/1817- 1737.25865.
17. R H Green, S J Singh, J Williams, M D L Morgan. A randomised controlled trial of four weeks versus seven weeks of pulmonary rehabilitation in chronic obstructive pulmonary disease. Thorax 2001; 56:143– 145.
18. DonraweeLeelarungrayub. Chest Mobilization Techniques for Improving Ventilation and Gas Exchange in Chronic Lung Disease. Chronic Obstructive Pulmonary Disease. Current Concepts and Practice 2000; 13:410-411.
19. Fuchs-Climent D, Le Gallais D, Varray A, Desplan J, Cadopi M, Préfaut C.Quality of life and exercise tolerance in chronic obstructive pulmonary disease: effects of a short and intensive inparticipant rehabilitation program. Am J Phys Med Rehabil. 1999; 78(4):330-5.
20. Gordon H Guyatt, Leslie B Berman, Marie Townsend. A measure of quality of life for clinical trials in chronic lung disease. Thorax 1987; 42:773-778.
21. Aeholland, knapman, DjBrazzale, Cj Hill, I Glaspole, N Goh, et al. Exercise prescription from 6-minute walk test achieves the suggested training intensity in interstitial lung disease. Austin Health, VIC 3084.
22. J.Alison. The validity of field walking tests in prescribing lower limb exercise intensity in clinical rehabilitation for people with chronic obstructive pulmonary disease. Australian New Zealand clinical trial registry 2012; 12609000439246.
23. Guyatt, G.H., L.B. Berman, M. Townsend. Long-term outcome after respiratory rehabilitation. CMAJ 1987; 137:1089-1095.
24. Zainuldin R,mackoy MG,Alison JA. Prescription of walking exercise intensity from the incremental shuttle walk test in people with chronic obstructive pulmonary disease.Am J Phys Med Rehabil 2012; 91:00- 00.
25. David C. Nieman. Fitness and Sports Medicine- A Health Related Approach. Mayfield Publishing Company 1995.
26. CorlnyKisner, Lynn Allen Colby. Therapeutics Exercise: Foundation and Techniques. 4th Ed. New Delhi: Jaypee Brothers, Medical Publishers 2002; 150-165.
27. The Australian Lung Foundation and Australian Physiotherapy Association.August 2009.
28. Troosters T, Gosselink R, Decramer M. Short- and long-term effects of outpatient rehabilitations in patients with chronic obstructive pulmonary disease: a randomized trial. Am J Med 2000; 109:207-212.
29. Russell S. Richardson. Skeletal muscle dysfunction vs muscle disuse in patients with COPD.J App Physio 1999;86:1751-1752.
30. Christine Cadena. COPD: Rehab Therapy Improves Lactic Acid and Improves Exercise and Mobility. An Overview of the Impact of Therapy2007; 45-58.
31. Carter R, Nicotra B, Clark L. Exercise conditioning in the rehabilitation of patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 1988; 69: 118-122.
32. Ries AL,Kaplan RM, Limberg TM, Lela M. Prewitt. Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Ann Intern Med 1995; 122:823-832.
ABBREVIATIONS USED: COPD :
Chronic Obstructive Pulmonary Disease CRQ: Chronic Respiratory Disease Questionnaire FEV1:Forced Expiratory Volume in One Second FVC:Forced Vital Capacity PR:Pulmonary Rehabilitation 6MWD:6 Minute Walk Distance