Respiratory Rehabilitation Exercises in Older Adults With Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Overview

The purpose of this randomized controlled trial was to evaluate the effects of a respiratory rehabilitation exercise training package on dyspnea, cough, exercise tolerance, and sputum expectoration of hospitalized elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Using purposive sampling, 61 participants were recruited and randomly assigned to either the experimental group (n = 30) or the control group (n = 31). The experimental group participants received the respiratory rehabilitation exercise training twice a day and 10-30 minutes per session for four days. The control group participants received usual care and health education. Data were collected at baseline and at the end of the four-day intervention.

Full Title of Study: “Efficacy of the Respiratory Rehabilitation Exercise Training Package in Hospitalized Elderly Patients With Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Randomized Control Trial”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Supportive Care
    • Masking: None (Open Label)
  • Study Primary Completion Date: December 2012

Detailed Description

The respiratory rehabilitation exercise training package included: (a) Disease awareness: The doctor explained the disease to patients and their families through the chest X-ray, (b) Sputum clearance treatments: Easily understood postural drainage cards were provided to the patients and families to assist with proper sputum clearance procedures, (c) Pursed lip breathing training: Devices were provided to the patients to ensure that the breathing exercises were completed properly, (d) Upper-limb exercise with breathing pranayama: Towels were provided to the patients to assist with upper-limb exercises properly, (e) Walking training with breathing pranayama: Legs were elevated while inhaling, and returned to the position while exhaling, and (f) Assign a pulmonary rehabilitation program coordinator: Coordinators were assigned to assist the patients in nutrition management and health education.

Interventions

  • Behavioral: Respiratory rehabilitation exercise training
    • The respiratory rehabilitation exercise training package was conducted twice a day and 10-30 minutes per session for 4 days: (a) disease awareness, (b) sputum clearance treatments, (c) pursed lip breathing training, (d) upper-limb exercise with breathing pranayama, (e) walking training with breathing pranayama, and (f) assign a pulmonary rehabilitation program coordinator.

Arms, Groups and Cohorts

  • Experimental: Experimental group
    • Respiratory rehabilitation exercise training 2 times/day, 10-30 minutes per session for 4 days.
  • No Intervention: Control group
    • Control group received usual care and health education.

Clinical Trial Outcome Measures

Primary Measures

  • Change from baseline in dyspnea at 4th day
    • Time Frame: At baseline and at the 4th day of the study
    • Measured by the Borg Rating of Perceived Exertion Scale.

Secondary Measures

  • Change from baseline in cough severity at 4th day
    • Time Frame: At baseline and at the 4th day of the study
    • Measured by the visual analog scale.
  • Change from baseline in exercise tolerance at 4th day
    • Time Frame: At baseline and at the 4th day of the study
    • Measured by the 6-minute walk distance
  • Change from baseline in sputum expectoration at 4th day
    • Time Frame: At baseline and at the 4th day of the study
    • Assessed by recording the patients’ feelings regarding sputum expectoration during the previous day.

Participating in This Clinical Trial

Inclusion Criteria

1. diagnosed with moderate COPD with moderate acute exacerbation

2. over 65 years of age

3. conscious clear

4. with shortness of breath or dyspnea that was not caused by heart disease, pneumothorax, or pulmonary edema

5. had received bronchodilator aerosol therapy or antibiotic treatment, but had not been treated with an antitussive

Exclusion Criteria

1. unstable vital signs

2. blood oxygen concentration lower than 90%

3. unstable psychological status, hemoptysis, pneumothorax, pulmonary edema, or using the respirator

Gender Eligibility: All

Minimum Age: 65 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Chest Hospital, Ministry of Health and Welfare, Taiwan
  • Provider of Information About this Clinical Study
    • Principal Investigator: Lin-Yu Liao, Head Nurse – Chest Hospital, Ministry of Health and Welfare, Taiwan
  • Overall Official(s)
    • Lin-Yu Liao, MS, Principal Investigator, Chest Hospital, Ministry of Health and Welfare, Taiwan

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