None listed
Conditions
Brief summary
This research is a prospective study of the CDSMP, with or without a supervised exercise component, in the Royal Hobart Hospital outpatient area for people with chronic obstructive pulmonary diesase. The research will use a mixed methodology of quantitative and qualitative outcome measures: physical activity, shortness of breath, health-related quality of life, stage of change for physical activity, self-efficacy for physical activity in the presence of deterrents and narratives of the lived experience of the participants themselves.
Interventions
(1) The intervention was supervised exercise added to the Chronic Disease Self-Management Program (CDSMP-Ex). See point two below for a description of the CDSMP.
Frequency - 1 session per week, held in the same week as the Chronic Disease Self-Management Program .
Intensity - the intensity of exercise was determined by using the modified Borg Rating of Perceived Exertion (RPE) Scale, aiming for a minimum of moderate intensity (RPE = 3) and not exceeding a strong intensity (RPE = 5).
Time (dura
(1) The intervention was supervised exercise added to the Chronic Disease Self-Management Program (CDSMP-Ex). See point two below for a description of the CDSMP. Frequency - 1 session per week, held in the same week as the Chronic Disease Self-Management Program . Intensity - the intensity of exercise was determined by using the modified Borg Rating of Perceived Exertion (RPE) Scale, aiming for a minimum of moderate intensity (RPE = 3) and not exceeding a strong intensity (RPE = 5). Time (duration of exercise session) - 1 hour Type - This general guideline was adjusted according to individual needs: 5 minutes of warm-up exercises 30 minutes of aerobic exercise (bicycle , treadmill, corridor walking, bicycle arm pedals) 5 minutes of stretching exercise (upper limb, lower limb, and trunk) 10 minutes of strengthening exercise (upper limb, lower limb, trunk with free weights, pulleys, steps, elastic bands, or fit ball) 5 minutes of cool-down exercises. Mode - Participants attended in a group, with each individual progressing according to their response to exercise. Exercise sessions were supervised by a trained physiotherapy assistant, with the physiotherapist readily available for consultation if needed. (2) The Chronic Disease Self-Management Program is a highly structured group-based 6-week workshop with sessions of 2½ hours duration offered once per week and facilitated by pairs of trained leaders.The leaders may be peers (others with a chronic condition) or health professionals who have undertaken 24 hours of training. It offers generic education about health-related behaviours: symptom management (anger, fear, frustration, depression, shortness of breath, fatigue, pain); breathing exercises; muscle relaxation; endurance exercise; cognitive symptom management; communication skills; advance directives for health care; working with and informing the healthcare team; medication usage and healthy eating. The CDSMP aims to facilitate the development of self-management self-efficacy (akin to confidence) through guided feedback sessions, problem-solving and completing action plans to achieve participant-defined goals. There is no supervised exercise component.
Sponsors
Menzies Research Institute
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Participants were required to meet the following criteria: be over 18 years; willing to attend a supervised exercise component; willing and able to commit to 8 weeks of attendance; have a diagnosis of chronic obstructive pulmonary disease (COPD) based on airflow limitation measured by spirometry (McKenzie, Frith & Burdon 2003) or a physician diagnosis and be at least 2 months post exacerbation. An exacerbation was defined as increased shortness of breath, increased mucus production, and purulent mucus (Bellamy, Booker & Fardy 2003; MacNee & Rennard 2004)
Exclusion criteria
Participants were ineligible if they had an intellectual disability, were unable to provide informed consent, were unable to complete a self-administered questionnaire, had previously attended a Chronic Disease Self-Management Program (CDSMP) or a comprehensive cardiopulmonary rehabilitation programme, within the past two years or were unable to safely undertake an exercise programme due to the presence of any one of the following conditions: uncontrolled cardiac conditions (resting systolic blood pressure > 180mm mercury and/or resting diastolic blood pressure > 110mm mercury, resting heart rate >120 beats per minute, unstable angina, severe cardiac valve disease, uncontrolled atrial or ventricular arrhythmias, uncompensated chronic heart failure, active pericarditis or myocarditis); recent vascular conditions (recent embolism or thrombophlebitis, active retinal haemorrhage, recent cerebrovascular accident); uncontrolled metabolic disorder (uncontrolled diabetes, retinopathy, acute thyroiditis, uncontrolled liver or renal disease, active cancer); severe orthopaedic problems; acute systemic illness or fever(Balady 2000).
Outcome results
None listed