Effects of a Physical Therapy Program in Hospitalized COPD Patients Due to an Acute Exacerbation

Abstract

PURPOSE: Acute exacerbation is a common cause of hospital admission in patients with chronic obstructive pulmonary disease (COPD). COPD also involves non-pulmonary manifestations including exercise intolerance and skeletal muscle dysfunction. These manifestations added to the hospitalization stay have been associated to a loss of muscle mass partially recovered 3 months after discharge. The aims of this study were to examine the effects of a physical therapy (PT) program in hospitalized patients due to an acute exacerbation of COPD (AE-COPD). METHODS: Randomized, single-blind controlled clinical trial. 60 AE-COPD patients were randomly assigned to a control group that received standard care or to an intervention group which additionally received PT. The participants included in the sample were both sex (92.85% men) at mean age of 71.1+/-10.094 years, with mean body mass index 27.66+/-5.315 Kg/m2. Mean length of hospital stay was 8.805+/-2.381 days. The patients who underwent PT received daily individualized physical activity focused on lower limbs resistance training during 30 minutes. The main outcome measures were lower limbs strength, muscle endurance and postural steadiness. These values were assessed using a digital dynamometer (N), the 2- minute step in place (number of times), and the one leg stance (s) tests, respectively and were evaluated at baseline and at discharge. RESULTS: The data analyses showed that lower limbs strength of participants in the PT group significantly increased pre to post hospitalization stay (right leg values 115.08+/-34.794;126.21+/-30.429; p=0.016; left leg 110.42+/-33.143;131.65+/-30.326; p<0.001*) . Postural steadiness increased significantly in left leg (2.62+/-2.291;6.00+/-6.949; p=0.020*) in PT group. Muscle endurance values also improved significantly in the PT group (43.00+/-24.357;63.85+/-25.822; p<0.001*). No significant differences pre to post treatment were found in values of the control group. CONCLUSIONS: The results show significant pre to post hospitalization stay improvement regarding a PT program focused on lower limbs exercises.