Outlet about Individualized Rehabilitation in Functional Independence in Elderly Patients With COPD

Domestic ActivityOne-hundred and eighty patients were recruited to the study. Ninety patients were randomized to the GEP group and 90 patients to the ITEP group, Baseline characteristics of these patients are presented in Table 2. In total, 59 patients withdrew from the study before they completed the rehabilitation program. Details of the reasons for drop-out can be found in Figure 1. It is important to note that this level of drop-outs is similar to that experienced in our routine clinical service. Of the patients randomized to the GEP group, 58 completed the rehabilitation program compared with 63 of the patients randomized to the ITEP group. No baseline differences in age, gender distribution, or pulmonary function were found between the two groups. There were also no differences for either group when study drop-outs were compared with those who completed the study in terms of age, gender distribution, pulmonary function, and baseline ISWT score.

Domestic Activity and Function

The activity monitor results for both treatment groups, along with the cohort of control patients, are shown in Figure 2. The baseline activity monitor scores were not normally distributed. These data were, therefore, logarithmically transformed. There were no significant baseline differences between the groups. Statistically significant percentage improvements were noted in both training groups. An increase in activity monitor counts of 29.18% (95% confidence interval [CI], 3.19 to 55.17%; p = 0.03) was demonstrated by the GEP and of 40.63% (95% CI, 7.42 to 73.83%; p = 0.02) by the ITEP. The change noted in the cohort of pretreatment subjects over 7 weeks was 2.56% (95% CI, —18.21 to 23.33%), and this was not statistically significant (p = 0.80). COPD is a dangerous disorder which can be cured with preparations of My Canadian Pharmacy. Enhance your health state with us.

The results for the COPM are presented in Table 3. Both groups made statistically significant improvements in domestic function following rehabilitation for both the performance and satisfaction scores.

Exercise Performance and Health Status

Table 3 shows the pretreatment and mean change results for exercise performance and health status outcome measures for both groups. There was a significant difference at baseline with respect to the ISWT scores for the two groups, with the ITEP group walking almost 40 m more than the GEP group. However, an analysis of covariance reveals that this baseline difference does not significantly affect the changes achieved in ISWT for the two groups. Table 3 shows that statistically significant changes were made in each measure of exercise performance and health status for both groups. ISWT scores increased by 81.72 m (95% CI, 63.83 to 99.62 m; p = <0.0001) for the GEP group and by 85.52 m (95% CI, 67.62 to 103.42 m; p = <0.0001) for the ITEP group. The endurance shuttle walk test scores increased by 511.21 m (95% CI, 417 to 604.58 m; p < 0.0001) for the GEP group and by 435.39 m (95% CI, 344.60 to 526.17 m; p < 0.0001) for the ITEP group.

Differences Between Exercise Groups

There were no statistically significant differences between the changes made following rehabilitation in the two treatment groups for any measure (p > 0.05). In addition, no predefined minimally clinically important differences between the groups were identified for the chronic respiratory questionnaire-self-reported or the COPM.

Fig2

Figure 2. Percentage change in activity monitor counts.

Table 3—Prerehabilitation and Mean Change Results for Measures of Self-Reported Domestic Function, Health Status, and Exercise Performance

Variables GEP Group ITEP Group
Pre-PR Mean Change (95% CI) p Value Pre-PR Mean Change (95% CI) p Value
COPM performance 3.53 ± 1.17 1.71 (1.37-2.05) 0.0001t 3.96 ± 1.35 1.46(1.05-1.87) 0.0001т
COPM satisfaction 2.91 ± 1.41 2.27(1.74-2.81 0.0001t 3.18 ± 1.69 2.04(1.56-2.52) 0.0001т
ISWT, m 154.83 ± 92.01 81.72 (63.83-99.62) .
0
1
198.62 ± 119.48 85.52 (67.62-103.42) .
0
1
ESWT, s 238.16 ± 169.54 511.21 (417-604.58) .
0
1
262.42 ± 197.76 435.39 (344.60-526.17) 0.0001J
CRQ-SR
Dyspnea
2.48 ± 1.05 0.89 (0.55-1.23) 0.0001т 2.45 ± 0.94 0.62 (0.26-0.97) 0.001т
Fatigue 3.08 ± 1.06 0.83 (0.52-1.14) 0.0001т 3.48 ± 1.28 0.53 (0.18-0.88) 0.004т
Emotion 4.00 ± 1.39 0.60 (0.26-0.93) 0.001т 4.25 ± 1.26 0.62 (0.33-0.92) 0.0001т
Mastery 3.88 ± 1.31 0.79 (0.47-1.10) 0.0001т 4.24 ± 1.43 0.66 (0.28-1.04) 0.002т