J Korean Med Sci.  2013 May;28(5):738-743. 10.3346/jkms.2013.28.5.738.

Effects of Home-Based Pulmonary Rehabilitation with a Metronome-Guided Walking Pace in Chronic Obstructive Pulmonary Disease

• Lee SS
• Kim C
• Jin YS
• Oh YM
• Lee SD
• Yang YJ
• Park YB

• KMID: 1777562
• DOI: http://doi.org/10.3346/jkms.2013.28.5.738

Abstract

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.

Keyword

Pulmonary Disease, Chronic Obstructive; Rehabilitation; Exercise Test; Quality of Life

MeSH Terms

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

Figure

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  Fig. 1 Home-based pulmonary rehabilitation protocol.

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  Fig. 2 Improved pulmonary and physical functions by exercise. (A) Six-minute walking distance (6MWD) and (B) St. George's Respiratory Questionnaire (SGRQ) score differences from baseline to 6 months after completion of rehabilitation.

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