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High intensity physical training in water: an effective training modality for patients with COPD
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
Umeå University, Faculty of Medicine, Department of Surgical and Perioperative Sciences, Sports Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Pulmonary Medicine.
2004 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 98, no 5, 428-438 p.Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to examine the effect of high intensity physical group training in water and on land for patients with COPD with regard to physical capacity and health related quality of life (HRQoL). A controlled, semi-randomised study was conducted where 30 patients were randomised to training either in water or on land. Thirteen patients constituted a control group. Forty-three outpatients, with moderate to severe COPD (27w/16m), from two local hospitals in northern Sweden, were included in the study. High intensity physical group training in water (water group) or on land (land group) was performed for 12weeks, three times per week, 45min per session. The control group received no intervention. Pre- and post-intervention, all patients performed incremental and endurance shuttle walking tests (ISWT and ESWT), cycle ergometer tests and responded questionnaires about HRQoL (St. Georges Respiratory Questionnaire--SGRQ and SF-36). The patients trained with a mean heart rate of 80-90% of peak heart rate. Both training groups increased the distance walked, i.e. land group in ISWT (25m) and water group in ESWT (179m). The water group increased the distance in ESWT significantly more that both the land and the control groups. Both training groups increased the time cycled (40-85s) and work load (10-20W) in the cycle ergometer test. The control group deteriorated in HRQoL according to total score in SGRQ while the training groups remained constant. The water group improved their activity score in SGRQ and their physical health score in SF-36 and those improvements were significant as compared to the land and the control groups. In conclusion, high intensity physical group training in water is of benefit for patients with COPD. It was in some areas found to be even more effective regarding improvements in physical capacity and experienced physical health compared to the same kind of training on land.

Place, publisher, year, edition, pages
2004. Vol. 98, no 5, 428-438 p.
Keyword [en]
Aged, Exercise Test, Exercise Therapy/*methods, Exercise Tolerance, Female, Forced Expiratory Volume/physiology, Health Status, Heart Rate/physiology, Humans, Hydrotherapy/*methods, Male, Middle Aged, Pulmonary Disease; Chronic Obstructive/physiopathology/*rehabilitation, Quality of Life, Treatment Outcome, Vital Capacity/physiology
Research subject
Physiotherapy
Identifiers
URN: urn:nbn:se:umu:diva-4241DOI: 10.1016/j.rmed.2003.11.010PubMedID: 15139572OAI: oai:DiVA.org:umu-4241DiVA: diva2:143251
Available from: 2004-11-12 Created: 2004-11-12 Last updated: 2017-12-14Bibliographically approved
In thesis
1. Physical training in patients with chronic obstructive pulmonary disease - COPD
Open this publication in new window or tab >>Physical training in patients with chronic obstructive pulmonary disease - COPD
2004 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Chronic obstructive pulmonary disease, COPD, places a substantial burden of disability on the growing number of patients and causes large costs for the society. Tobacco smoke is the most important risk factor. Progressive exertional dyspnea is the major symptom which leads to diminished physical and social activities, reduced physical capacity and decreased health related quality of life, HRQoL.

The aim of this thesis was to evaluate different physical training modalities in patients with COPD with regard to physical capacity and HRQoL. Patients with moderate to severe COPD were included in the studies. In the first intervention, 20 patients trained on a treadmill with or without supplemental oxygen, three times per week, during eight weeks. In the second intervention, 30 patients were randomised to high-intensity group training either in water or on land, and 13 patients were included in a control group. The patients in the water and land groups trained three times per week during three months and once a week during the following six months.

Oxygen supplementation during physical training did not enlarge the positive effects of the same training with air in patients with exercise-induced hypoxaemia. Both groups improved the distance walked after training. High-intensity group training in water and on land was found to be effective with regard to walking distance and HRQoL compared to the control group. Training in water seemed to be of greater benefit compared to training on land concerning walking distance and experienced physical health when the training was accomplished three times per week. The thigh muscle strength increased after training in both the water and the land group. The muscle endurance in knee extension was low in the majority of the patients and was not improved after the training intervention. An evaluation of the long-term effects of physical group training and the effects of decreased training frequency showed that training with low frequency (once a week) during six months did not seem to be sufficient to maintain the level achieved after a three months period of higher frequency training (three times per week). However, the two periods combined seemed to prevent decline in physical capacity and HRQoL compared to baseline.

The conclusion is that physical training is of benefit for patients with COPD with regard to physical capacity and HRQoL. Training can be performed individually or in groups, with high intensity, in water and on land. It is also concluded that the training can, under controlled conditions, be performed without supplemental oxygen even in patients with exercise-induced hypoxaemia.

Publisher
89 p.
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 917
Keyword
Physical therapy, Chronic obstructive pulmonary disease, Physical training, Oxygen, Water training, Group training, Physical capacity, Health related quality of life, Long-term effect, Sjukgymnastik
National Category
Physiotherapy
Identifiers
urn:nbn:se:umu:diva-363 (URN)91-7305-732-0 (ISBN)
Public defence
2004-12-04, 11:00 (English)
Opponent
Available from: 2004-11-12 Created: 2004-11-12 Last updated: 2009-08-07Bibliographically approved

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