Efficacy and safety of physical therapy in patients with stage III COPD during ambulatory rehabilitation

Abstract

This study aimed to determine the efficacy of a combined physical therapy and pharmacological treatment for patients recovering from stage III COPD exacerbation. The efficacy of the rehabilitation program was assessed using anthropological parameters, physical condition, respiratory system function, and functional endurance capacity. Data were collected from 39 patients with stage III COPD who underwent the rehabilitation program. Physical and anthropometric assessments were conducted using the Quetelet Body Mass Index, the Pignet Index, and the Vital Capacity Index (VCI). The functional capacities of the cardiorespiratory system were measured before and after the rehabilitation program using the Ruffier and Ruffier-Dickson tests and the hypoxic Shtange and Genchi tests. Exercise tolerance was evaluated using the Harvard Step Test and the Six-Minute Walk Distance Test (6MWD). Statistical analysis was conducted using the non-parametric Mann-Whitney U test for independent and dependent groups. Participants were randomly divided into two groups for rehabilitation: Group I received standard therapy and a routine physical therapy program, while Group II was given standard therapy along with a modified physical therapy regimen. There was a slight improvement in patient condition during the rehabilitation period for both groups. However, there was a low compliance rate for smoking cessation among the majority of patients, with some reducing their daily cigarette intake. Further long-time research is required to determine the efficacy of the proposed physical therapy program in combination with basic pharmacological therapy. The study suggests incorporating psychotherapeutic sessions and occupational therapy into future rehabilitation programs.

Keywords: BBI-P - Pignet Body-Built Index; BMI - Body Mass Index; COPD - Chronic Obstructive Pulmonary Disease; FC - Functional Class; FEV - Forced Expiratory Volume; FEV1 - First Second of Forced Expiration; FEV1/FVC - First Second of Forced Expiration/Forced Vital Capacity; RDt - Ruffier-Dickson Test; Rt - Ruffier Test; VCI - Vital Capacity Index; chronic obstructive pulmonary disease; physical therapy; rehabilitation program.

Figure 1

Rehabilitation scheme for patients included in the study * Application of ozokerite on the interscapular area, and aerosol and electro aerosol therapy were also used (1-2% solution of baking soda, sea salt, saline-alkaline mineral water, decoctions of plantain, coltsfoot, sage, mucolytic agents). The duration of the procedure was 15 to 30 minutes. **stroking, squeezing, rubbing, and kneading techniques were used. Additionally, vibration, hitting, and shaking techniques were used as well. *** Endurance and rhythmic exercise: The program incorporated exercises designed to gradually increase patient endurance. These activities were uniquely combined with choreographic elements to make the sessions engaging and enjoyable. Exercises varied in speed, rhythm, direction, and amplitude of movements, and were conducted to the accompaniment of rhythmic music styles such as foxtrot, Charleston, tango, disco, rock-n-roll, and breakdance.

Figure 2

Distribution of study participants by age

Figure 3

Distribution of study participants by smoking status

Figure 4

Corresponding BMI distribution between age groups: 40-59 years vs. ≥60 years