Physical training in patients with chronic obstructive pulmonary disease – COPD

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 a vital risk factor. Progressive exertional dyspnea is the key indicator which results in reduced physical and social activities, lowered physical capacity and diminished health related quality lifestyle, HRQoL.The purpose of this thesis was to examine various physical training modalities in patients with chronic obstructive pulmonary disease COPD regarding physical capacity and HRQoL. Sufferers with modest to serious COPD were part of the studies. In the 1st intervention, twenty patients trained on a treadmill machine with or without additional oxygen, three times per week, throughout eight weeks. In the 2nd intervention, 30 patients were randomised to high-intensity group training either in water or on land, and thirteen sufferers were included in a control group. The sufferers within the water and land groups trained 3 times each week during 3 months and once per week through the subsequent 6 months. Oxygen supplements during physical training didn’t enlarge the positive results of the same training with air in patients with exercise-induced hypoxaemia. Both teams increased the distance walked after training. High-intensity group training in water and on land was discovered to be efficient regarding walking distance and HRQoL when compared to control group. Training in water appeared to be of higher benefit when compared with training on land concerning walking distance and experienced physical wellness once the training was completed 3 times every week. The thigh muscle power improved after training in both the water and the land group…

Contents: Physical training in patients with chronic obstructive pulmonary disease – COPD

Prevalence and incidence
Risk factors
Consequences of chronic obstructive pulmonary disease COPD
Health related quality of life
Exercise limitation
Nutritional abnormalities and weight loss
Skeletal muscle dysfunction

Abnormal structure and function of skeletal muscles
Pulmonary rehabilitation
Physical training
Different training modalities
Training with oxygen
Training in water
Long term effects of training
Rationale for this thesis
Specific research questions
Intervention programmes
Walking on treadmill
Training in water and on land
Walking tests
Six minute walking distance test – 6MWD
Incremental shuttle walking test – ISWT
Endurance shuttle walking test – ESWT
Cycle ergometer tests
Metabolic stress test
Knee muscle strength and endurance
Maximal dynamic strength in knee extension and knee flexion
Dynamic endurance in knee extension
Blood lactate
Oxygen saturation, SpO2
Arterial oxygen saturation, SaO2
Transcutaneous carbon dioxide, TcpCO2
Heart rate monitoring
Perceived exertion, dyspnea and leg fatigue
Body composition
Health related quality of life
St George’s Respiratory Questionnaire – SGRQ
Medical outcome Short Form-36 – SF-36
Activity level questionnaire
Statistical analysis
Training attendance
Physical capacity
Walking distance
Oxygen uptake – VO2peak
Work load
Time cycled
Dynamic muscle strength and endurance
Body composition
Health related quality of life
St George’s Respiratory Questionnaire
Short Form
Activity level questionnaire..
Muscle tests
HRQoL questionnaires…

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Source: Umea University

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