Generic, symptom based, exercise rehabilitation; integrating patients with COPD and heart failure

R.A. Evans, R. Collier, I. Loke, M.C. Steiner, M.D.L. Morgan, Sally J. Singh

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    Abstract

    Patients with Chronic Heart Failure (CHF) develop similar symptoms of exertional breathlessness and fatigue as patients with COPD. Although pulmonary (exercise based) rehabilitation (PR) is an integral part of the management of COPD, the potential for exercise rehabilitation (ER) to assist patients with CHF may not be as readily appreciated. We investigated whether combined ER for patients with CHF and COPD was feasible and effective using the model of PR. Methods 57 patients with CHF were randomized 2:1 to 7 weeks ER (CHF-ER) or 7 weeks of usual care (CHF-UC). As a comparator 55 patients with COPD were simultaneously recruited to the same ER program (COPD-ER). The primary outcome measure was the Incremental Shuttle Walk Test (ISWT) and the secondary outcome measures were the Endurance Shuttle Walk Test (ESWT), isometric quadriceps strength and health status. Results 27 CHF and 44 COPD patients completed ER and 17 patients with CHF completed UC. The CHF-ER group made significant improvements, compared to CHF-UC, in the mean (95%CI) ISWT distance; 62(35–89)m vs −6(−11 to 33)m p <0.001. The CHF-ER group also made statistically significant improvements in health status. The improvements in exercise performance and health status were similar between patients with CHF and COPD, treated with ER. Conclusion Patients with CHF who undergo ER improve similarly in their exercise performance and health status to COPD. Combined training programs for COPD and CHF are effective and feasible, such that service provision could be targeted around common disability rather than the primary organ disease.
    Original languageEnglish
    Pages (from-to)1473-1481
    JournalRespiratory Medicine
    Volume104
    Issue number10
    DOIs
    Publication statusPublished - Oct 2010

    Keywords

    • Chronic obstructive pulmonary disease
    • Chronic heart failure
    • Pulmonary rehabilitation
    • Exercise
    • Dyspnea
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    Evans, R. A., Collier, R., Loke, I., Steiner, M. C., Morgan, M. D. L., & Singh, S. J. (2010). Generic, symptom based, exercise rehabilitation; integrating patients with COPD and heart failure. Respiratory Medicine, 104(10), 1473-1481. https://doi.org/10.1016/j.rmed.2010.04.024