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Enfermedad pulmonar obstructiva cronica entrenamiento domiciliario versus ambulatorio Hospitalario (Home-based versus ambulatory hospital-based training in COPD) [Spanish] |
Jolly E, Sivori M, Villarreal S, Almeida M, Saenz C |
Medicina 2014;74(4):293-300 |
clinical trial |
5/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
There is little experience on the effect of home training (rD) in patients with chronic obstructive pulmonary disease (COPD). Our aim was to compare the effect of rD on exercise tolerance, dyspnea and quality of life versus hospital outpatient training (rH). Two random groups of 25 patients were evaluated. Both trained during 8 weeks (24 sessions); undergoing various tests before and after, such as spirometry, questionnaires on dyspnea (MRC, Mahler and Borg) and on quality of life (SF-36 and St George's), submaximal (6 minutes' walk, resistance-shuttle and cycle-ergometer endurance time limit (Tlim), and -- maximal exercise tests (shuttle -- ST -- and cardiopulmonary test). The rH group performed aerobic and strength for lower limbs (MI) and upper (MS) exercises. The rD group performed walks at 70% of the speed reached in ST and strength exercises for MI and MS. The basal condition was similar in both groups. The Tlim increased, 125% (p = 0.0001) for rH group and 63% (p = 0.0011) for rD, showing no significant differences. They also improved distance in shuttle resistance (77%, p = 0.0421 in rH and 79%, p = 0.0197 in rD group) and in 6 minutes' test (12% in rD, p = 0.0135). St George scoring was reduced only in the rH group (p = 0.0034); 32% abandoned in rD versus 20% in rH (p = 0.4521). Effectiveness in rD training was equal to rH for COPD patients, although rD were more likely to abandon the program.
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