Effects of exercise therapy aiming at improvement in physical fitness on dyspnea and health-related QoL in patients with chronic obstructive pulmonary disease

Abstract

Pulmonary rehabilitation is a common therapy for improving both exercise tolerance and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD). Although exercise is an important rehabilitation strategy, walking, treadmill use, bicycling and respiratory muscle training can be monotonous. A comprehensive exercise program that includes recreational activities may be a more effective means to decrease the occurrence of dyspnea during daily activities and improve QoL in patients with COPD. The purpose of this study was to investigate the effects of our exercise therapy, including recreational activities and respiratory muscle training, on dyspnea and health-related QoL (HRQL) in COPD patients. Thirty-eight male patients with COPD were randomly assigned to a control (C) (70.1±6.4 yr) (n=12). pulmonary rehabilitation (PR) (70.3±8.3 yr) (n=16), or exercise (EX) (68.7±4.6 yr) (n=10) group. The following evaluations were performed at baseline and at 8 weeks: (1) cycle ergometer test; (2) 6-min walking distance; (3) physical fitness; (4) pulmonary function; (5) dyspnea; and (6) HRQoL (SF-36). The C group showed no significant changes in physical fitness, pulmonary function, dyspnea, and HRQoL scores throughout the observation period. There was a significant (P<0.05) improvement in 6-min walking distance, physical fitness maximum inspiratory pressure (MIP), and HRQoL for the PR group. The EX group demonstrated a significant (P<0.05) improvement in physical fitness, maximum expiratory pressure (MEP), dyspnea, and HRQoL. Moreover, the degree of improvement in each variable was greater for EX than for PR. There were significant (P<0.05) correlations between MIP and FEV1.0 (r=0.65), and between MEP and FEV1.0 (r=0.43). Based on these results, it appears that our comprehensive exercise program, including recreational activities and respiratory muscle training, improves physical fitness, pulmonary function, dyspnea, and quality of life in COPD patients.