None listed
Conditions
Brief summary
Method: A randomised trial with allocation concealment, assessor blinded to group allocation and intention-to-treat analysis was conducted. Two hundred and sixty-seven people with COPD [mean age 72(9) years, FEV1 59(23)% predicted] were allocated to receive either eight weeks of twice-weekly group exercise training plus education or exercise training alone. Education was disease specific with a self-management focus. Primary outcome measures included six-minute walk distance and Chronic Respiratory Questionnaire. Secondary outcomes included dyspnoea, health behaviours, generic health related quality of life, self-efficacy, and healthcare usage with measurements taken immediately following completion and at six and 12 months. Results: There were no significant differences that indicated greater improvement in any health outcome with the addition of education. The two intervention groups had similar significant improvements immediately following intervention, and these were maintained comparably in the subsequent 12 months. Conclusions: The results of this investigation suggest that disease-specific group education is not an essential component of pulmonary rehabilitation. Pulmonary rehabilitation based on exercise training is an effective option in the management of patients with COPD if multidisciplinary education cannot be offered.
Interventions
Participants will be randomized to receive either exercise training or exercise training and disease specific group self-management education. All participants will under go twice weekly exercise training sessions consisting of aerobic and strength training programs (duration of one hour of exercise) for eight weeks (total of 16 sessions). Those randomized to the self-management education group will also receive twice weekly education sessions conducted by a multidisciplinary team for eight we
Participants will be randomized to receive either exercise training or exercise training and disease specific group self-management education. All participants will under go twice weekly exercise training sessions consisting of aerobic and strength training programs (duration of one hour of exercise) for eight weeks (total of 16 sessions). Those randomized to the self-management education group will also receive twice weekly education sessions conducted by a multidisciplinary team for eight weeks. Each session will be an hour in duration, and topics covered will include how to self-manage, the lungs and COPD management, airway clearance, managing breathlessness, stress, anxiety and depression, sexuality issues, continence, exercise and physical activity, nutrition and healthy eating, medications, community resources, energy conservation techniques and swallowing. To complement the group sessions, participants will also receive a booklet on the above topics and an action plan diary. The focus of the sessions is on facilitating behaviour change rather than delivery of information.
Sponsors
Felicity Blackstock
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
0 to No maximum
Healthy volunteers
No
Inclusion criteria
Primary diagnosis of COPD as classified by NHLBI/WHO Global Initiative for COPD: FEV1 of <80% predicted and a FEV1/FVC ratio of < 70% (as measured with a vitalograph) - Participant reported symptomatic dyspnea (shortness of breath) interfering with their ability to perform normal activities of daily living.
Exclusion criteria
Attendance at pulmonary rehabilitation program in the preceding two years- Non-English speaking- A primary diagnosis of another chronic respiratory conditions (for example bronchiectasis, cystic fibrosis, pulmonary fibrosis, or lung carcinoma) - Another condition which would limit their ability to exercise (e.g. arthritis, cardiac conditions, lower back pain, Parkinson's disease)- A medically documented cognitive condition which would limit their ability to learn (e.g. Alzheimer's, dementia, short term memory loss following stroke or head injury).
Outcome results
None listed