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Long-term Effects of 1-Year Maintenance Training on Physical Functioning and Health Status in Patients With COPD: A Randomized Controlled Study

Ringbaek, Thomas MD, PhD; Brøndum, Eva RN; Martinez, Gerd PT; Thøgersen, Jane RN; Lange, Peter MD, PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: January-February 2010 - Volume 30 - Issue 1 - p 47–52
doi: 10.1097/HCR.0b013e3181c9c985
Pulmonary Rehabilitation

PURPOSE To examine whether maintenance training (MT) for 1 year improved the long-term effects of a 7-week chronic obstructive pulmonary disease (COPD) rehabilitation program.

METHODS After a 7-week outpatient rehabilitation program, 96 patients with COPD were randomized to either an MT group (n = 55) or a control group (n = 41). Both groups were requested to continue unsupervised training at home. The MT group received weekly supervised training the first 6 months, supervised training every second week the next 6 months, and finally no supervised training the last 6 months of the 18-month study period. Primary effect parameters were Endurance Shuttle Walk Test (ESWT) time and health status (St. George's Respiratory Questionnaire, SGRQ). Secondary effect parameters were adherence to supervised training, dropout rates, and hospitalization.

RESULTS Compared with the control group, the MT group had significantly better ESWT times at 3 and 6 months (+43.9 seconds; P= .03, and +75.1 seconds; P= .02) and insignificantly higher ESWT time at 12 months (+66.6 seconds; P= .40). SGRQ total score declined gradually after the 7-week program with no difference between the 2 groups, and after 18 months, the score was 1.7 units (95% confidence interval: −0.7 to 4.1) worse than at randomization. There was no difference between the 2 groups regarding dropout rates or hospitalization.

DISCUSSION Weekly MT for 12 months improved walking time but had no influence on health-related quality of life or hospital admissions, compared with unsupervised daily training at home. The effect of the MT was closely related to adherence to the program.

The effect of maintenance training (MT) after a 7-week chronic obstructive pulmonary disease rehabilitation program was examined in a randomized trial with 55 active patients and 41 controls. Weekly supervised MT for 12 months improved walking time but had no influence on health-related quality of life or hospital admissions compared with unsupervised daily training at home.

Pulmonary Rehabilitation Research Group, Department of Cardiology and Respiratory Medicine, University Hospital of Copenhagen, Hvidovre, Denmark.

Corresponding Author: Thomas Ringbaek, MD, PhD, Pulmonary Rehabilitation Research Group, Department of Cardiology and Respiratory Medicine, University Hospital of Copenhagen, DK-2650 Hvidovre, Denmark (ringbaek@dadlnet.dk).

© 2010 Lippincott Williams & Wilkins, Inc.