Effects Of Aerobic And Resistance Training In Patients With Severe COPD Undergoing Pulmonary Rehabilitation

objectives:The primary objective of this paper was to assess patients’understanding, adherence, and barriers to implementation of GOLD guidelines in China.We also evaluated the effects of aerobic and resistance training on exercise capacity, health-related quality of life (HRQL), anxiety and depression, dyspnea, pulmonary function, C-reactive protein (CRP) in patients with severe COPD.Methods:We investigated200patients who have had COPD for at least one year through a telephone interview. The main contents we investigated included patients’medical profile, patients’understanding, adherence, and barriers to implementation of GOLD guidelines. Thirty patients who volunteered to participate in this study were subsequently randomized to pulmonary rehabilitation (PR) or the control group. The control group was given conventional therapy and PR group was given extra6weeks of combined aerobic and resistance training in addition to conventional therapy. Exercise capacity, health-related quality of life (HRQL), anxiety and depression, dyspnea, pulmonary function, C-reactive protein (C-RP) were measured before and after training.Results:1.There were only31%patients who adhered to regular bronchodilator medications.The long-term administration of oxygen (>15hours per day) was1%with95%of patients having a sedentary lifestyle.2%of the patients who had heard of pulmonary rehabilitation. The biggest barrier to implementation of GOLD guidelines in China was found to be financial constraints. The major barriers to enrollment in PR included cost (19%), disruption to the patient’s routine(19%), transportation problems (17%), severe depressed mood (13%), and lack of perceived benefit (12%).2.6MWD (461.50+95.802m vs518.44+84.62m, p<0.01) and 30-second sit-to-stand up-down test (STS)(17.47±3.94per30s vs24.53±3.98per30s,p<0.01),30-second arm curl test (ACT)(18.6±2.82per30s vs26.07±3.41per30s,p<0.01) in PR patients increased significantly. HRQL(CAT) and dyspnea (MRC) improved in the PR (p<0.05). Anxiety and depression improved in PR (p<0.05). Plasma CRP levels in PR reduced from6.5mg/1(2.0mg/1-6.7mg/1) to1.5mg/1(0.6mg/1-2.0mg/1),p<0.05.There was no change in pulmonary function in both groups. However, the control group did not experience any improvement in the measured outcomes (p>0.05).Conclusion:Exercise-based pulmonary rehabilitation significantly improves treatment outcomes in Chinese patients with severe COPD. Additionally, patients’adherence to the GOLD guidelines is extremely poor among Chinese patients with COPD. Educational programs and financial assistance are urgently needed to increase awareness and ensure implementation of guideline-based management of COPD patients in China.