Pulmonary Disease, Chronic Obstructive Clinical Trial
Official title:
Effects of Unsupported Upper Extremity Exercise Training in Patients With Chronic Obstructive Pulmonary Disease: a Randomized Clinical Trial
Recent guidelines on pulmonary rehabilitation (PR) recommend upper extremity exercise
training (UEET) in patients with chronic obstructive pulmonary disease (COPD).
The theory supporting the inclusion of upper extremity exercise training in the pulmonary
rehabilitation for these patients, is based on the profound understanding of the activity of
the accessory respiratory muscles, which are competitively involved in both the support of
the upper extremities during activities and the ventilation. However, a systematic review of
the literature carried out by our staff reveals that the clinical trials carried out up to
now to verify the effectiveness of UEET are of poor methodological quality and the
investigators cannot corroborate the recommendation recently made on the basis of the
results of the investigators' review.
Therefore the investigators began this randomized, parallel groups, controlled clinical
trial with the purpose of determining the short-term effect of unsupported UEET on the
performance of the upper extremities and on symptoms perceived during activities by patients
with COPD.
We recruited inpatients with stable, moderate or severe COPD referred to the PR program at
the regional centre of Villa Pineta Hospital.
Patients were randomized into two groups: control and intervention. Patients randomized to
the control group undertook an inpatient comprehensive PR that complied with the
recommendations made by the ATS/ERS and included a minimum of 15 daily sessions of specific
training for lower extremities.
Patients randomized to the intervention group undertook an experimental program consisting
of 15 additional daily sessions of unsupported UEET over and above the same PR program used
for control patients.
Measurements of upper extremity performance and symptoms perceived were taken in both groups
at baseline (T0) and at the completion of the interventions (Tend) by one physiotherapist
unaware to the patient's group allocation. To verify if the experimental training leads to
long-term results on the functional arm exercise capacity, some measurements were repeated
at 6-months as the latest follow-up (T6months).
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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