The Effect Of Unsupported Arm Exercise Rehabilitation On Patients With COPD

Objective:To investigate the effectiveness of Unsupported Arm Exercise(UAE)on patients with COPD. To explore an appropriate upper limb rehabilitation method which can be applied to Chinese COPD patients, and we hope this rehabilitation exercise can decrease the burden of patients themselves and their families.At last,the method can spread around COPD population,and can make a progress in their quality of life.Methods: This is a randomized controlled trial.70 patients from the respiratory department of The First Affiliated Hospital of Dalian Medical University were recruited from March 2014 to October 2014.According to the random numbers generated by computer,participants were assigned to the intervention group or the control group,every group has 35 patients. The control group received usual care including the correct way of respiratory exercise, encourage patients to quit smoking,guidance about dairy and pharmacotherapy. During the same period the intervention group received UAE on the basis of usual care.The rehabilitation contains five movement,patients did the exercise once a day for 6 weeks, it toke about30 minutes a day.Outcome measures:Basic Dyspnoea Index(BDI),6-minutes Pegbord and Ring Test(6PBRT),COPD Assessment Test(CAT) and Borg scale.We collected the data at baseline and 6 week.The data was analyzed using SPSS 19.0. The descriptive statistics analysis,X 2test,non-paraetric test, two independent sample t test and two paired sample t test were used.Results:1. There are 61 patients completed the research.30 in the control group and 31 in the intervention group.Any patients doesn’t appear uncomfortable symptoms,injury and acute exacerbation during the 6 weeks.The majority of the participants in both groups were male(80.3%) and the average age was 70.59.There was no statistical difference between two groups regarding age,sex,marital status,living status,degree of education,profession,income,smoking status and so on.2.Comparison among groups.After the 6-week UAE rehabilitation,the intervention group’s upper exercise endurance,quality of life(CAT) and BDI were significantly improved compared to baseline(171.60±32.532 vs 199.13±34.564,P=0.000;21.03±4.047 vs 18.17±3.788,P=0.000;8.53±1.907 vs 9.30±1.725,P=0.000),but the result of Borg scale doesn’t change(2.87±1.074 vs 2.80±0.847,P=0.702).After 6 weeks in the control group,the upper limb endurance improved(164.19 ± 33.208 vs 168.52 ± 37.954, P=0.005),while the CAT,BDI and Borg scale doesn’t change(20.87±3.528 vs 20.87±3.263,P=1.000;8.00±2.066 vs8.10±1.832,P=0.655;3.10±1.274 vs 2.97±0.795,P=0.572).3. Comparison between groups.There was no statistical difference between groups at the baseline.After 6 weeks,compared with the control group,the magnitude of change in the intervention group was greater for the upper limb endurance,CAT and BDI(P=0.002;P=0.004;P=0.011),there was no between-group difference in Borg scale(P=0.428).Then we compared the mean changes in all the measurements after six weeks in both groups,and we got the same results.Conclusion:1. This research confirmed the effectiveness of UAE on patients with COPD,UAE can improve the upper limb activity endurance and reduce the burden of respiratory muscles.2. UAE can relieve the dyspnoea symptom caused by acvitities of daily livingusing arms,it increases the capacity of daily living and improves the patients’ quality of life.3. UAE is a useful rehabilitation method which is applicable for COPD patients,and should be recommended to COPD patients.