BACKGROUNDChronic obstructive pulmonary disease (COPD) is a major public health problem worldwide. Pulmonary rehabilitation (PR) is an established intervention for the management of patients with COPD. Exercise training is an important part of PR, and its effectiveness in patients with COPD is well established. However, alternative methods of PR training such as Daoyin have not been appropriately studied. Hence, alternative forms of exercise training that require less exercise equipment and no specific training place should be evaluated. This paper describes the study protocol of a clinical trial that aims to determine if pulmonary Daoyin training will improve the exercise capacity and psychosocial function of patients with COPD in China.

METHODS AND DESIGNA multicenter, randomized, controlled trial will be conducted. A total of 464 patients meeting the inclusion criteria will be enrolled into this study with 232 patients in each of the trial group and the control group. Based on patient education, patients in the trial group will receive pulmonary Daoyin and continue with their usual therapy for three months. In the control group, patients will continue with their usual therapy. The primary outcome measures are exercise capacity assessed by the six-minute walking distance test and lung function. Secondary outcomes include dyspnea and quality of life. Measurements will be taken at baseline (month 0) and after the study period (month 3).

DISCUSSIONIt is hypothesized that pulmonary Daoyin will have beneficial effects in improving exercise capacity and psychosocial function of patients with stable COPD, and will provide an alternative form of exercise training that is accessible for the large number of people with COPD.

TRIAL REGISTRATIONThis trial has been registered in ClinicalTrials.gov. The identifier is NCT01482000.

Adolescent ; Adult ; Aged ; Breathing Exercises ; China ; Female ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; psychology ; rehabilitation ; therapy ; Research Design ; Young Adult

OBJECTIVE: To evaluate the effect of health education on the symptoms, lung function and life quality in patients with stable chronic obstructive pulmonary diseases (COPD). METHODS: Eighty-two patients were assigned into 2 groups randomly: The treatment group (n = 43) accepted health education for 6 months and the control group (n = 39) did not. Before and after the 6 months, we observed the number of smokers, Borg score, inhale treatment, times of acute episode, SGRQ score, lung function, and the therapeutic effect in the two groups. RESULTS: Six months later, the ratio of smokers in the treatment group was 13.95%, much lower than that in the control group (35.90%, P = 0.021); the Borg score of the treatment group decreased from 4.86 +/- 1.21 to 3.38 +/- 0.94 (P =0.000), but there was no difference in the control group; the ratios of accepted inhale treatment in the treatment group and the control group were 100% (43/43) and 20.51 % (8/39) respectively (P = 0.000), and the accuracy rates were 100% (43/43 ) in the treatment group and 12. 82% (5/39) in the control group (P =0. 000); the times of acute episode in the treatment group was 1.51 +/- 1.53, much lower than that in the control group (4.46 +/- 5.17, P = 0. 000); the indexes of lung function before and after the 6 months between the two groups had no significant difference. The total score, the symptom section score, the activity section score, and the impact section score of SGRQ after the 6 months of health education were much lower than those of 6 months before, and those in the control group had no significant difference. CONCLUSION Six months of the health education can decrease the ratio of smokers and the times of acute episode, and to improve the life quality of patients with stable COPD.
Adult ; Aged ; Female ; Health Education ; Humans ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; psychology ; rehabilitation ; Quality of Life ; Respiratory Function Tests ; Surveys and Questionnaires

Despite documented efficacy and recommendations, pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) has been underutilized. Home-based PR was proposed as an alternative, but there were limited data. The adequate exercise intensity was also a crucial issue. The aim of this study was to investigate the effects of home-based PR with a metronome-guided walking pace on functional exercise capacity and health-related quality of life (HRQOL) in COPD. The subjects participated in a 12-week home-based PR program. Exercise intensity was initially determined by cardiopulmonary exercise test, and was readjusted (the interval of metronome beeps was reset) according to submaximal endurance test. Six-minute walk test, pulmonary function test, cardiopulmonary exercise test, and St. George's Respiratory Questionnaire (SGRQ) were done before and after the 12-week program, and at 6 months after completion of rehabilitation. Thirty-three patients participated in the program. Six-minute walking distance was significantly increased (48.8 m; P = 0.017) and the SGRQ score was also improved (-15; P < 0.001) over the six-month follow-up period after rehabilitation. There were no significant differences in pulmonary function and peak exercise parameters. We developed an effective home-based PR program with a metronome-guided walking pace for COPD patients. This rehabilitation program may improve functional exercise capacity and HRQOL.
Aged ; Exercise ; Exercise Test ; Female ; *Home Care Services, Hospital-Based ; Humans ; Lung/physiopathology ; Male ; Middle Aged ; Program Evaluation ; Pulmonary Disease, Chronic Obstructive/physiopathology/*rehabilitation ; Quality of Life ; Questionnaires ; Respiratory Function Tests ; Treatment Outcome ; *Walking

OBJECTIVE: To investigate the effect of exercise therapy on activity of daily living (ADL) and lung function in patients with chronic obstructive pulmonary disease (COPD). METHODS: A total of 122 patients with moderate to severe COPD received routine treatment.The patients were divided into 2 groups randomly. Sixty-two patients in the experimental group received respiratory training on the basis of respiratory pathophysiology and aerobic exercise for 1 year. Medical research council scale (MRC) score, ADL score, 6-min walking distance, and lung function were measured. RESULTS: The MRC grade after the exercise therapy was lower than that before the exercise therapy in the experimental group (P<0.01) and the control group (P<0.05). The ADL score and 6-min walking distance increased compared with that before the respiratory training (P<0.05).After the respiratory training, the ADL score and 6-min walking distance had significant difference between the experimental group and the control group (P<0.05). CONCLUSION Long term and individual exercise therapy can relieve dyspnea, and improve the exercise tolerance and quality of life in COPD patients.
Activities of Daily Living ; Aged ; Aged, 80 and over ; Breathing Exercises ; Exercise Therapy ; Female ; Humans ; Lung ; physiopathology ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; physiopathology ; rehabilitation ; Quality of Life ; Respiratory Function Tests