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

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posted on 2023-05-18, 05:06 authored by Cameron-Tucker, HL, Wood-Baker, R, Christine Owen, Joseph, L, Eugene WaltersEugene Walters
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.

History

Publication title

The International Journal of Chronic Obstructive Pulmonary Disease

Volume

9

Pagination

513-523

ISSN

1176-9106

Department/School

Tasmanian School of Medicine

Publisher

Dove Medical Press Ltd.

Place of publication

New Zealand

Rights statement

Licensed under Creative Commons Attribution-NonCommercial 3.0 United States (CC BY-NC 3.0 US) http://creativecommons.org/licenses/by-nc/3.0/us/

Repository Status

  • Open

Socio-economic Objectives

Clinical health not elsewhere classified

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