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[The effect of controlled and uncontrolled dynamic lower extremity training in the rehabilitation of patients with chronic obstructive pulmonary disease].
Orv Hetil 2005; 146(44):2249-55OH

Abstract

Pulmonary rehabilitation has become a part of the integrated management of patients with chronic obstructive pulmonary disease (COPD). The lower extremity dynamic training has been proved to be the most effective element of the program.

OBJECTIVE

Does the supervised training have more favorable effect in case of similar program?

PATIENTS AND METHODS

In two groups: 54 patients, supervised (group K, n = 22) and not supervised (group NK, n = 32) by physiotherapists, chosen at random have been investigated. Both groups consisted of hospitalized patients of the same severity (forced expiratory volume in one second) [FEV1 (average +/- SD)]: K: 51.0 +/- 16.1 vs. NK: 51.9 +/- 15.6% pred). Group K performed physiotherapist-supervised cycling training in the Pulmonology Ambulance Unit 3-4 times a week for 45 minutes doing an 8-week period and group NK performed training in the form of cycling, stepping on stairs or dynamic walking at home with the same duration, weekly periodicity and time interval.

RESULTS

After rehabilitation vital capacity (VC) (K: 3.0 +/- 0.8 vs. 3.3 +/- 0.7 l, p < 0.05), emphysema ratio (RV/TLC): K: 53.5 +/- 10.1 vs. 51.6 +/- 9.9, p < 0.05) in the supervised group, and alveolar volume (VA) in the not supervised group (NK: 4.3 +/- 0.9 vs. 4.7 +/- 0.9 l, p < 0.05) significantly improved. Improvement of exercise capacity was more effective in group K (K: 92.7 +/- 33.9 vs. 106.4 +/- 34.5 W, p < 0.001; NK: 95.8 +/- 36.7 vs. 99.9 +/- 35.1 W, p < 0.05). In both groups aerobic capacity (VO2: K: 1.2 +/- 0.4 vs. 1.3 +/- 0.4 l/min, p < 0.01, NK: 1.1 +/- 0.4 vs. 1.2 +/- 0.4 l/min, p < 0.01; VO2/kg: K: 16.1 +/- 5.5 vs. 17.5 +/- 5.8 ml/kg/mm, p < 0.01, NK: 16.2 +/- 5.3 vs. 16.7 +/- 4.8 ml/kg/ min, p < 0.01) and anaerobic threshold level [AT (pred VO2%)] (K: 36.6 +/- 9.8 vs. 42.8 +/- 10.2%, p < 0.001; NK: 40.8 +/- 12.0 vs. 44.6 + 11.6%, p < 0.001) significantly improved. Heart rate reserve: (K: 17.7 +/- 22.7 vs. 28.8 +/- 31.5 l/min, p < 0.01; NK: 20.4 +/- 21.2 vs. 25.0 +/- 21.6 l/min, p < 0.01) improved at the same level of exercise. The Borg scale of dyspnea (0-10): (K: 6.4 +/- 2.5 vs. 5.7 +/- 2.7, p < 0.05; NK: 7.5 +/- 1.8 vs. 6.9 +/- 2.2, p < 0.05) was reduced and quality of life score (0-24): K: 11.5 +/- 0.7 vs. 9.0 +/- 2.8, p < 0.005; NK: 11.6 +/- 2.3 vs. 7.0 +/- 1.9, p < 0.005) was improved.

CONCLUSION

In both group dynamic lower extremity training caused improvement in exercise capacity. The favorable metabolic effect of training was shown by the change of anaerobic threshold resulting in less carbon dioxide production during analogous exercise. This reduction led to less ventilation reducing the work of breathing in supervised group. The more favorable adaptation taking place in the group supervised by physiotherapists might have resulted from the controlled higher intensity of the training.

Authors+Show Affiliations

Szegedi Tudományegyetem, Szent-Györgyi Albert Orvos- es Gógyszerésztudományi Centrum, Altalános Orvostudományi Kar, Tüdogyógyászati Tanszék, Csongrád Megyei Onkormányzat Mellkasi Betegségek Szakkórháza, I. Tüdoosztály, Deszk. jvarga@deszk.szote.u-szeged.huNo affiliation info availableNo affiliation info available

Pub Type(s)

Controlled Clinical Trial
English Abstract
Journal Article

Language

hun

PubMed ID

16302356

Citation

Varga, János, et al. "[The Effect of Controlled and Uncontrolled Dynamic Lower Extremity Training in the Rehabilitation of Patients With Chronic Obstructive Pulmonary Disease]." Orvosi Hetilap, vol. 146, no. 44, 2005, pp. 2249-55.
Varga J, Boda K, Somfay A. [The effect of controlled and uncontrolled dynamic lower extremity training in the rehabilitation of patients with chronic obstructive pulmonary disease]. Orv Hetil. 2005;146(44):2249-55.
Varga, J., Boda, K., & Somfay, A. (2005). [The effect of controlled and uncontrolled dynamic lower extremity training in the rehabilitation of patients with chronic obstructive pulmonary disease]. Orvosi Hetilap, 146(44), pp. 2249-55.
Varga J, Boda K, Somfay A. [The Effect of Controlled and Uncontrolled Dynamic Lower Extremity Training in the Rehabilitation of Patients With Chronic Obstructive Pulmonary Disease]. Orv Hetil. 2005 Oct 30;146(44):2249-55. PubMed PMID: 16302356.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [The effect of controlled and uncontrolled dynamic lower extremity training in the rehabilitation of patients with chronic obstructive pulmonary disease]. AU - Varga,János, AU - Boda,Krisztina, AU - Somfay,Attila, PY - 2005/11/24/pubmed PY - 2006/1/19/medline PY - 2005/11/24/entrez SP - 2249 EP - 55 JF - Orvosi hetilap JO - Orv Hetil VL - 146 IS - 44 N2 - UNLABELLED: Pulmonary rehabilitation has become a part of the integrated management of patients with chronic obstructive pulmonary disease (COPD). The lower extremity dynamic training has been proved to be the most effective element of the program. OBJECTIVE: Does the supervised training have more favorable effect in case of similar program? PATIENTS AND METHODS: In two groups: 54 patients, supervised (group K, n = 22) and not supervised (group NK, n = 32) by physiotherapists, chosen at random have been investigated. Both groups consisted of hospitalized patients of the same severity (forced expiratory volume in one second) [FEV1 (average +/- SD)]: K: 51.0 +/- 16.1 vs. NK: 51.9 +/- 15.6% pred). Group K performed physiotherapist-supervised cycling training in the Pulmonology Ambulance Unit 3-4 times a week for 45 minutes doing an 8-week period and group NK performed training in the form of cycling, stepping on stairs or dynamic walking at home with the same duration, weekly periodicity and time interval. RESULTS: After rehabilitation vital capacity (VC) (K: 3.0 +/- 0.8 vs. 3.3 +/- 0.7 l, p < 0.05), emphysema ratio (RV/TLC): K: 53.5 +/- 10.1 vs. 51.6 +/- 9.9, p < 0.05) in the supervised group, and alveolar volume (VA) in the not supervised group (NK: 4.3 +/- 0.9 vs. 4.7 +/- 0.9 l, p < 0.05) significantly improved. Improvement of exercise capacity was more effective in group K (K: 92.7 +/- 33.9 vs. 106.4 +/- 34.5 W, p < 0.001; NK: 95.8 +/- 36.7 vs. 99.9 +/- 35.1 W, p < 0.05). In both groups aerobic capacity (VO2: K: 1.2 +/- 0.4 vs. 1.3 +/- 0.4 l/min, p < 0.01, NK: 1.1 +/- 0.4 vs. 1.2 +/- 0.4 l/min, p < 0.01; VO2/kg: K: 16.1 +/- 5.5 vs. 17.5 +/- 5.8 ml/kg/mm, p < 0.01, NK: 16.2 +/- 5.3 vs. 16.7 +/- 4.8 ml/kg/ min, p < 0.01) and anaerobic threshold level [AT (pred VO2%)] (K: 36.6 +/- 9.8 vs. 42.8 +/- 10.2%, p < 0.001; NK: 40.8 +/- 12.0 vs. 44.6 + 11.6%, p < 0.001) significantly improved. Heart rate reserve: (K: 17.7 +/- 22.7 vs. 28.8 +/- 31.5 l/min, p < 0.01; NK: 20.4 +/- 21.2 vs. 25.0 +/- 21.6 l/min, p < 0.01) improved at the same level of exercise. The Borg scale of dyspnea (0-10): (K: 6.4 +/- 2.5 vs. 5.7 +/- 2.7, p < 0.05; NK: 7.5 +/- 1.8 vs. 6.9 +/- 2.2, p < 0.05) was reduced and quality of life score (0-24): K: 11.5 +/- 0.7 vs. 9.0 +/- 2.8, p < 0.005; NK: 11.6 +/- 2.3 vs. 7.0 +/- 1.9, p < 0.005) was improved. CONCLUSION: In both group dynamic lower extremity training caused improvement in exercise capacity. The favorable metabolic effect of training was shown by the change of anaerobic threshold resulting in less carbon dioxide production during analogous exercise. This reduction led to less ventilation reducing the work of breathing in supervised group. The more favorable adaptation taking place in the group supervised by physiotherapists might have resulted from the controlled higher intensity of the training. SN - 0030-6002 UR - https://www.unboundmedicine.com/medline/citation/16302356/[The_effect_of_controlled_and_uncontrolled_dynamic_lower_extremity_training_in_the_rehabilitation_of_patients_with_chronic_obstructive_pulmonary_disease]_ L2 - http://www.diseaseinfosearch.org/result/7979 DB - PRIME DP - Unbound Medicine ER -