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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.

Item Type:	Refereed Article
Keywords:	supervised exercise, physical capacity, 6-minute walk distance
Research Division:	Biomedical and Clinical Sciences
Research Group:	Cardiovascular medicine and haematology
Research Field:	Respiratory diseases
Objective Division:	Health
Objective Group:	Clinical health
Objective Field:	Clinical health not elsewhere classified
UTAS Author:	Cameron-Tucker, HL (Dr Helen Cameron-Tucker)
UTAS Author:	Wood-Baker, R (Professor Richard Wood-Baker)
UTAS Author:	Owen, C (Dr Christine Owen)
UTAS Author:	Walters, EH (Professor Haydn Walters)
ID Code:	96587
Year Published:	2014
Web of Science® Times Cited:	20
Deposited By:	Medicine
Deposited On:	2014-11-12
Last Modified:	2017-11-01
Downloads:	356 View Download Statistics