Home exercise program improves activities of daily living, quality of life, health status perception and dyspnea in patients with chronic obstructive pulmonary disease

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is characterized by a progressive limitation of expiratory airflow and that has systemic changes capable of producing exercise intolerance and progressive dyspnea on increasingly minor efforts, including activities of daily living (ADL). Pulmonary rehabilitation (PR) is the main non-pharmacological strategy used to treat these patients. PR programs, centered on home exercises, seem to be an alternative, safe model that can improve access and adherence to PR programs. Objective: The objective was to evaluate the effects of home exercises, self-performed, in the ADL, in the perception of dyspnea, in the health status, and in the quality of life of patients with COPD. Methods: Quasi-experimental study (before-and-after), of the effects of home exercises for two months, three times a week, with a total of 24 sessions. Before and after training, patients underwent ADL assessments with the AVD-Glittre test, dyspnea by mMRC, health status through the COPD Assessment Test (CAT) and quality of life with Saint George's Respiratory Questionnaire (SGRQ). Results: Differences were observed in the time of the AVD-Glittre test ([95% CI 0.19;1.27]; p = 0.008), the sensation of dyspnoea ([95% CI 0.18; 1.24]; p = 0.009), the perception of health status ([95% CI 1.61;10.61]; p = 0.04) and quality of life ([95% CI 1.88;26.10]; p = 0,05) in the studied population. We also observed a weak and statistically significant correlation between the AVD-Glittre test and the mMRC (r = 0.35; [95% CI 0.09;0.56]; p = 0.009) and a moderate and statistically significant correlation. between the AVD-Glittre test and the CAT (r = 0.5; [95% CI 0.30;0.69]; p <0.001), and between the AVD-Glittre test and the SGRQ (r = 0,50; [95% CI 0.27; 0.67]; p <0.001) and a strong and statistically significant correlation between CAT and SGRQ (r = 0.86; [95% CI 0.77; 0,91]; p <0.001). Conclusion: After two months, patients with COPD can benefit from self- performed home exercises, guided by an illustrated booklet, since this proposal improves ADLs, quality of life, health perception and dyspnea.