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Generic, symptom based, exercise rehabilitation; integrating patients with COPD and heart failure.
MedLine Citation:
PMID:  20650624     Owner:  NLM     Status:  In-Process    
BACKGROUND: 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.
R A Evans; S J Singh; R Collier; I Loke; M C Steiner; M D L Morgan
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-07-21
Journal Detail:
Title:  Respiratory medicine     Volume:  104     ISSN:  1532-3064     ISO Abbreviation:  Respir Med     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8908438     Medline TA:  Respir Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  1473-81     Citation Subset:  IM    
Dept. of Respiratory Medicine, Allergy and Thoracic Surgery, University Hospitals of Leicester NHS trust, Glenfield Hospital, Leicester, United Kingdom.
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