Effect Of Functional Fitness Training On Exercise Endurance And Quality Of Life In Stable COPD Patients

Objective:Conventional drug therapy is not enough to improve exercise intolerance and decreased quality of life in COPD patients due to abnormal cardiopulmonary function and skeletal muscle function.In this study,functional fitness training was used to intervene in stable COPD patients.To observe the effects of functional fitness training on exercise endurance,health-related quality of life,symptoms,anxiety,depression,comprehensive score and lung function in COPD patients.Method:A total of 34 COPD subjects meeting the inclusion criteria were screened out in Taiyuan Heping Community Health Service Center through the screening and diagnostic criteria for high-risk COPD groups.According to the FEV₁%index of lung function test results,34 patients were paired in pairs and then randomly divided into two groups.The experimental group（combination group）was functional physical fitness training+conventional treatment group（17 patients）,and the control group（conventional group）was conventional treatment group（17 patients）.Both groups received health education,and a total of 28 patients completed the study.The conventional treatment group was drug therapy,the original drug therapy regimen remained unchanged for the patients who had received drug therapy before,and the patients diagnosed for the first time were given symptomatic drug therapy by respiratory physicians.The functional fitness training group received aerobic training,resistance training,balance training and flexibility training.Aerobic training was performed by power bicycle with exercise intensity of 60%～70%HRmax,3 times a week,and maintained for 30 minutes after reaching the target intensity each time.Resistance training The compound tension wall was used for orthostatic forward and backward push on the upper limb,and the quadriceps muscle training instrument was used for the lower limb.The exercise intensity was 30%1-RM for the upper limb and50%1-RM for the lower limb,twice a week,2 groups each time,15 in each group.Balance function training adopted heel walking as exercise program,5 times a week,10 minutes each time;The flexibility training effectively pulls the muscle groups of the upper and lower limbs.Each group of muscle groups is stretched for 3 consecutive sets of 15 to 20 seconds,5 times a week.Before intervention,four weeks after intervention and eight weeks after intervention,the patients were evaluated by using the mMRC scale,6MWT,CAT scale,SAS scale,SDS scale,BODE index and lung function test.The data were input by Excel and analyzed by SPSS 23.0 software.The measurement data were expressed by mean±standard deviation（x±s）or median（25th percentile,75th percentile）[Md（P25,P75）].For those with normal distribution and homogeneity of variances,one-way analysis of variance was used for in-group comparison.The t test of two independent samples was used for comparison between groups,and the rank sum test was used for non-normal distribution.Count data by quantity（%）[n（%）],rate comparison by Chi Square（Χ²）test.P<0.05 was considered to be statistically significant.Results:mMRC score:Within group:the combination group improved 1.00±0.00 points after 8 weeks of intervention compared with before intervention,and 0.80±0.41points after 8 weeks compared with 4 weeks of intervention,P<0.05;After 4 weeks of intervention,the improvement of the conventional group was 0.60±0.51 points compared with before intervention,and after 8 weeks,the improvement was 0.80±0.56 points compared with before intervention,P<0.05.Intergroup:After 8 weeks of intervention,the combined group improved 0.13±0.74 points compared with the conventional group,P>0.05.BODE index:Within group:after 8 weeks of intervention,the combined group improved 1.27±0.46 points compared with before intervention,P>0.05;After 8weeks of intervention,the conventional group improved 0.33±0.49 points compared with before intervention,P>0.05.Intergroup:After 8 weeks of intervention,the combined group was 0.6±1.30 points better than the conventional group,P>0.05.SAS score:Within group:after 8 weeks of intervention,the combined group improved 4.00±1.25 points compared with before intervention,P<0.05,after 8weeks of intervention,compared with 4 weeks of intervention,2.67±0.99 points improved,P<0.05;After 8 weeks of intervention,the conventional group improved0.40±0.74 points compared with before intervention,P>0.05.Intergroup:After 8weeks of intervention,the combined group was 3.50±2.68 points better than the conventional group,P<0.05.SDS score:Within group:the combination group was 3.47±1.81 points better after 8 weeks than before intervention,P<0.05,and 2.00±1.07 points better after 8weeks than after 4 weeks,P<0.05;After 8 weeks of intervention,the conventional group improved 0.60±0.51 points compared with before intervention,P>0.05.Intergroup:After 4 weeks of intervention,the combined group was 1.16±3.15 points better than the conventional group,P<0.05;After 8 weeks of intervention,the combined group was 2.33±2.79 points better than the conventional group,P<0.05.CAT score:Within group:after 8 weeks of intervention,the combined group improved 4.53±1.46 points compared with before intervention,P<0.05;After 8weeks of intervention,the improvement of the conventional group was 2.47±1.25points compared with before intervention,P>0.05.Intergroup:After 8 weeks of intervention,the combined group was 2.07±4.56 points better than the conventional group,P>0.05.6MWD:Within group:4 weeks after intervention,the combined group improved35.03±11.25m compared with before intervention,P<0.05;8 weeks after intervention,improved 71.64±11.84m compared with before intervention,P<0.05;After 8 weeks of intervention,the conventional group improved 36.33±15.62m compared with before intervention,P<0.05.Intergroup:After 4 weeks of intervention,the combined group improved 32.17±1.92m compared with the conventional group,P<0.05;After 8 weeks of intervention,the combined group was52.46±45.15m better than the conventional group,P<0.05.FEV₁%:Within group:The combination group improved by 0.56±0.65%after8 weeks of intervention compared with before intervention,P>0.05;After 8 weeks of intervention,the improvement of the conventional group was 0.30±1.03%compared with that before intervention,P>0.05.Intergroup:After 8 weeks of intervention,the combined group improved 0.41±1.90%compared with the conventional group,P>0.05.Conclusion:Functional fitness training combined with conventional therapy can significantly increase the 6MWD and improve the exercise endurance of patients with stable COPD.Functional fitness training combined with conventional therapy can significantly reduce CAT scores and improve quality of life in stable COPD patients.Functional fitness training combined with conventional therapy significantly reduce the mMRC score and improve the dyspnea during exercise in stable COPD patients.Functional fitness training combined with conventional therapy can significantly reduce SAS and SDS scores and improve anxiety and depression in stable COPD patients.