Effects of a supervised home exercise program on patients with severe chronic obstructive pulmonary disease.

The purpose of this study was to analyze the effects of a home exercise program on physical work capacity and dyspnea during activities of daily living in patients with severe chronic obstructive pulmonary disease. Twenty patients with severe respiratory impairment were assigned in a stratified, random manner to an Exercise Group (n = 10) or a Control Group (n = 10). Patients in the Exercise Group performed the supervised home exercise program of daily mobility, strengthening, and endurance exercises. Patients in the Control Group were visited regularly by a physical therapist but did not follow the exercise program. Six patients were eliminated from the study, either because of death (n = 1) or noncompliance with experimental conditions (n = 5), leaving each group with seven patients. The results of a progressive bicycle ergometer test after 18 weeks showed a significant between-group difference in physical work capacity. The physical work capacity of patients in the Exercise Group had improved 3% and had deteriorated 28% for patients in the Control Group (p less than .05). The symptom-limited multistage step test and the Chronic Respiratory Disease Questionnaire showed no difference in the patients' physical work capacity or dyspnea during ADL. Although not conclusive, this study yielded some evidence for the beneficial effects of home exercise training on patients with severe chronic obstructive pulmonary disease.