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

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Cameron-Tucker, HL and Wood-Baker, R and Owen, C and Joseph, L and Walters, EH, Chronic disease self-management and exercise in COPD as pulmonary rehabilitation: a randomized controlled trial, The International Journal of Chronic Obstructive Pulmonary Disease, 9, (1) pp. 513-523. ISSN 1176-9106 (2014) [Refereed Article]


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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/

DOI: doi:10.2147/COPD.S58478

Abstract

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 18.646.2 m; CDSMP-alone (control group) by 20.046.2 m. There was no significant difference for any secondary outcome.

Conclusion: The CDSMP produced 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 Details

Item Type:Refereed Article
Keywords:supervised exercise, physical capacity, 6-minute walk distance
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Respiratory Diseases
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Respiratory System and Diseases (incl. Asthma)
Author:Cameron-Tucker, HL (Dr Helen Cameron-Tucker)
Author:Wood-Baker, R (Professor Richard Wood-Baker)
Author:Owen, C (Dr Christine Owen)
Author:Walters, EH (Professor Haydn Walters)
ID Code:96587
Year Published:2014
Web of Science® Times Cited:5
Deposited By:Medicine (Discipline)
Deposited On:2014-11-12
Last Modified:2017-11-01
Downloads:198 View Download Statistics

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