The Science Journal of the American Association for Respiratory Care

2011 OPEN FORUM Abstracts


Rossella Cavalli, Simona Sommariva, Roberta De Carli, Paola Seminari, Antonia Zucca, Mariano Scozzafava, Francesco Tursi, Sara Forlani; Respiratory Rehabilitation, Azienda Ospedaliera Provincia di Lodi, Sant'Angelo Lodigiano, Italy

BACKGROUND: Arm exercise training is recommended in the guidelines for pulmonary rehabilitation. The rehabilitation adherence is mostly related to self-determined motivation and the autonomy support training can increase it. METHODS: A randomized controlled clinical trial non double-blind, included 32 admitted patients in Pulmonary Rehabilitation between January 2010 and May 2011 with moderate and severe COPD. Were excluded patients with COPD exhacerbation or heart failure in place and also cancer patients. Patients were randomly assigned to an intervention (n=16) or control group (n=16). Active cycle of breathing techniques and leg exercise was used in both arms. The control group underwent arm supported training only on working days, whereas the intervention group also during hospitalization weekends, when the intervention group patients used arm cycle ergometry Daven Bike for 30 minutes in the morning and in the afternoon and a training diary. The global performance, were measured using 6MWT. Dyspnea during activity of daily living (ADL) and health-related quality of life (HRQL) were measured using the SGQR. MRC and BORG scale were used to grading the degree of a patient's breathlessness. For each patient were also calculated the multidimensional BODE index. RESULTS: Premising that there was not any baseline difference between both groups, in the intervention group was greater for total SGRQ score, SGRQ symptom score, SGRQ activity score or SGRQ impact score. at hospital discharge in increase of 6MWD at discharge. Both groups significantly improved 6MWD post-training in comparison with baseline, but no significant difference were observed. No significant difference between the two groups even the BORG and MRC score. CONCLUSIONS: We observe that patients who have conducted training of the upper limbs with supported exercise by Daven Bike continuously, obtained a more marked improvement of health-related quality of life compared with the control group. Despite the overall improvement of the tolerance to exercise at hospital discharge, there was no additional benefit resulting from four hours of additional arm work during hospitalization. We are expanding the series and we are also introducing the assessment of arm function and exercise capacity in the limbs using the 6-min pegboard and ring test (6PBRT).
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