Long-term (1-year) effects of two methods of exercise training (ET) in COPD patients

Introduction: the success of long-term ET programs resides in the integration between exercise prescription and patients' compliance with home training. Aim: to evaluate two methods to help understanding and maintaining the exercise (walking) intensity. Methods: 36 COPD patients (9F,27M) participated to the ET program (age 72 ±8; FEV1% 48±12). T0= first evaluation: 6MWD, tests on treadmill to evaluate walking distance covered in twenty minutes (20MWD) and maximal speed, monitoring of physical activity (Armband). Patients were then divided in 2 groups for the home ET program: A1= speed walking marked by a metronome; A2=covering a known distance in a fixed time. Test were repeated after 5 and 12 months (T5;T12). Control group: 23 well matched COPD not partecipating in ET (8F,15M,age 69±7,FEV1% 52±11) Results: Group A1-A2. Daily METs Physical activity > 3 METs (hours) 6MWD (m) Max speed (Km/h) 20MWD (m) A1 T0 1,22±0,13 0,39±0,38 299±87 3,7±1,1 790±292 A2 T0 1,29±0,21 0,66±0,56 261±94 3,6±1,2 726±250 A1 T5 1,31±0,16* 0,95±0,86* n.a. 4,0±1,2* 970±363* A2 T5 1,36±0,22* 1,11±0,77* n.a. 3,9±0,3 868±334* A1 T12 1,39±0,16*^ 0,96±0,64* 369±80* 4,5±1,2*^ 1028±335*^ A2 T12 1,33±0,25 0,97±0,67^ 315±92* 4,2±1,4* 840±320* * vs T0 ; ^ vs T5 Control group: no significant change.Conclusions: ET performed at a metronome-marked speed allows the patient to better understand the intensity of exercise and is more effective with time, as shown by the mantaining of higher physical activity and performance after 12 months in A1 compared to A2. ^*=p