Chronic Obstructive Pulmonary Disease (COPD) Clinical Trial
Official title:
The Effects of a Home Exercise Video Programme for Patients With Chronic Obstructive Pulmonary Disease:Pilot Study
Patients with COPD, suffer symptoms of breathlessness and leg weakness. Exercise programmes in the form of pulmonary rehabilitation (PR) have been shown to improve both of these symptoms significantly. PR involves patients attending a hospital or community centre. For some patients, leaving the house is an ordeal. This study investigated the effectiveness of an exercise video programme delivered in the patients home.
Pulmonary Rehabilitation (PR) has been shown to deliver cost-effective improvements in
dyspnoea, exercise tolerance and health-related quality of life (HRQoL) in people with
chronic obstructive pulmonary disease (COPD). PR programmes in the United Kingdom (UK) are
typically delivered on an outpatient basis, either at a hospital or suitable site in the
community. It is not always possible however, for patients to access outpatient programmes
due to lack of local availability or adequate transport from isolated locations. Severe
breathlessness may reduce activity levels to such a degree that for many leaving the house
is an ordeal. A British Lung Foundation (BLF) survey reported that less than 2% of UK COPD
patients had access to a rehabilitation exercise programme, despite National Institute for
Health and Clinical Excellence (NICE) and British Thoracic Society (BTS) recommendations
that PR be made available to all patients who are functionally limited by dyspnoea. Meeting
the demand for PR remains a challenge.
Access to the benefits of PR may be broadened if effective exercise could be administered at
home. Current evidence suggests that home-based rehabilitation interventions result in
smaller benefits as judged by exercise tolerance and quality of life when compared to
supervised programmes. The impact of home based rehabilitation may be limited by multiple
factors including, lack of health care professional supervision and lack of support from
fellow COPD sufferers. This lack of support may lead to poor adherence to prescribed
exercise intensity and frequency in home programmes.
One-to-one supervision on an individual basis is unlikely to be feasible or cost-effective,
however, use of a home exercise video could enhance adherence to prescribed exercise
programmes. Video media can be an effective means of delivering exercise instruction. No
published research to date has investigated the effectiveness of a home exercise video for
patients with COPD. We hypothesised that an exercise programme based on video instruction at
home, could improve walking ability, breathlessness and quality of life.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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