Tailored exercise is safe and beneficial for acutely hospitalised older adults with chronic obstructive pulmonary disease
- Nicolás Martínez-Velilla1,2,5,
- Pedro L. Valenzuela3,5,
- Fabricio Zambom-Ferraresi1,2,5,
- Mikel L. Sáez de Asteasu1,2,5,
- Robinson Ramírez-Vélez1,2,
- Antonio García-Hermoso1,2,
- Alejandro Lucia2,4,6 and
- Mikel Izquierdo1,2,6⇑
- 1Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain
- 2CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain
- 3Department of Systems Biology, University of Alcalá, Madrid, Spain
- 4Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
- 5These authors have contributed equally
- 6These authors share senior authorship
- Mikel Izquierdo, Department of Health Sciences, Public University of Navarra, Av. De Barañain s/n 31008 Pamplona, Navarra, Spain. E-mail: mikel.izquierdo{at}gmail.com
Abstract
Exercise rehabilitation programs have proven to increase exercise capacity and quality of life (QoL) in hospitalised patients with COPD. However, controversy exists as to the actual safety and effectiveness of this type of intervention We assessed the effects of an individualised exercise program on the functional capacity of acutely hospitalised older adults with COPD (as assessed with Barthel index and physical performance (Short Physical Performance Battery [SSPB]). Depression and QoL indicators, as well as serum C-reactive protein [CRP] and red blood cell distribution width [RDW] were also determined. Exercise-related side effects and incidence of readmission and mortality at 3 and 12-month–follow-up were also reported. We used the intention-to-treat approach. Of the 370 patients initially included in the RCT (11), 86 with COPD were identified (40 and 46 for the control and intervention group, respectively. The median length of stay was 8d (interquartile range, 4) for both groups. The exercise intervention improved all functional and physical performance-related outcomes (Barthel index, SPPB, 1RM leg strength) as well as depression and QoL scores, but no significant changes were found for CRP or RDW. No side effects associated were noted with the exercise sessions. No between-group differences were found for the incidence of readmission at 3 or 12-month follow-up; or for the incidence of mortality at 3 or 12-month follow-up. Our findings add to the existing limited literature supporting the benefits and safety of early rehabilitation programs in acutely hospitalised, older patients with COPD. Of note, the fact that our results were found in very older people (87 years on average) strengthens the potential safety of this type of interventions.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Martínez-Velilla has nothing to disclose.
Conflict of interest: Dr. Valenzuela has nothing to disclose.
Conflict of interest: Dr. García-Hermoso has nothing to disclose.
Conflict of interest: Dr. Lucia has nothing to disclose.
Conflict of interest: Dr. Izquierdo has nothing to disclose.
Conflict of interest: Dr. Zambom has nothing to disclose.
Conflict of interest: Dr. Ramírez-Vílez has nothing to disclose.
Conflict of interest: Dr. Saez de Asteasu has nothing to disclose.
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- Received April 7, 2020.
- Accepted June 12, 2020.
- Copyright ©ERS 2020