ABSTRACT
BACKGROUND: Exercise training is key to the comprehensive management of patients with chronic obstructive pulmonary disease (COPD). Interactive game-based systems have been proposed to improve effectiveness and compliance with exercise training. AIM: To evaluate the effectiveness of Wii Fit balance board as an additional tool for exercise training in patients with COPD. As a secondary aim we will evaluate the costs. METHODS: In a randomized controlled trial, patients were divided into experimental (EG) and control (CG) groups. The CG performed exercise training on a cycle ergometer three times a week for 6 weeks. The EG also followed a program (yoga, strength training, aerobic exercise) using the Wii Fit system. Pre and post treatment six-minute walking distance (6MWD) test, transitional dyspnea index (TDI), the Medical Research Council (MRC) score the Saint George's Respiratory Questionnaire (SGRQ), the body max index, airflow obstruction, dyspnea, and exercise capacity index (BODE) were assessed. RESULTS: The 6MWD increased from 410.7 (105.3) to 477.5 (122.4) and from 376.6 (81.0) to 420 (77.6) meters, in CG and EG respectively, p=0.0001 without any difference between groups. Both groups experienced significant improvements in TDI and SGRQ, but not in MRC and BODE, without any significant difference between groups. CONCLUSION: A Wii Fit balance board based video game program was feasible but did not add any benefit to a well conducted standard exercise training program in patients with COPD.
Subject(s)
Exercise Therapy/methods , Pulmonary Disease, Chronic Obstructive/rehabilitation , Video Games , Aged , Dyspnea/etiology , Exercise Therapy/economics , Exercise Therapy/instrumentation , Exercise Tolerance , Female , Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/complications , Resistance Training , Severity of Illness Index , Surveys and Questionnaires , Video Games/economics , Walk Test , YogaABSTRACT
BACKGROUND AND OBJECTIVE: There are barriers to providing pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) such as the high number of patients, difficult access to health facilities and high costs of programs. Pedometers can monitor and improve physical activity (PA). The aim of this study was to evaluate benefits and costs of home pedometer assisted PA, as compared to a standard outpatient supervised exercise training program in patients with COPD. METHODS: Patients were randomly assigned either to home pedometer assisted PA (Group 1), or to a six-week outpatient standard supervised exercise training program (Group 2). Patients of Group 1 had to walk at home for 6 weeks, at least 30min daily at the fastest step pace as possible, to achieve a weekly 10% increase in their average daily steps up to more than 6500. Pre and post programs we assessed: the six minute walking distance (6MWT: primary outcome), daily steps count, the Medical Research Council scale (MRC), the COPD assessment test score, and the BODE index (body-mass index, airflow obstruction, dyspnea, exercise capacity). Costs of programs were also evaluated. RESULTS: Out of 40 patients, 18 in both groups (mean (standard deviation)) age: 68.3 (6.7) and 61.2 (6.7) years; FEV1: 1.1 (0.5) and 0.9 (0.4) liters in Group 1 and 2 respectively completed the study. At the end of the program 44.5% patients of Group 1 had reached the target daily steps, in 26.6 (9.5) days. Following the programs, both groups showed significant improvements in all outcome measures, except BODE. The home program was cheaper (p=0.0001), with a mean 76.3 euros saving per patient. CONCLUSION: Home pedometer assisted PA may be a useful and cheaper alternative to outpatient supervised exercise training programs in patients with COPD.
Subject(s)
Actigraphy/economics , Cost-Benefit Analysis , Exercise , Pulmonary Disease, Chronic Obstructive , Adult , Aged , Female , Humans , Male , Middle Aged , Pulmonary Disease, Chronic Obstructive/physiopathologyABSTRACT
Survival of critically ill patients is frequently associated with significant functional impairment and reduced health-related quality of life. Early physiotherapy of acute respiratory distress syndrome (ARDS) patients has recently been identified as an important therapeutical tool and has become an important evidence-based component in the management of these patients. Nevertheless, availability and quality of physiotherapy performed in intensive care units (ICUs) is often inadequate. The aim of this review is to describe recent progresses in application of physiotherapy in ARDS patients. The assessment and evidence-based treatment of these patients should include prevention and reduction of adverse consequences of immobilization and weaning failure. A variety of modalities of early physiotherapy in ICU are suggested by clinical research and should be applied according to the stage of disease, comorbidities, and patient's level of cooperation. Early ICU physiotherapy is an interdisciplinary team activity, involving physical therapists, occupational therapists, nurses and medical staff.
