Effect of home-based pulmonary rehabilitation using a woven rubber chain on the quality of life of COPD patients in Chiang Dao district, Chiang Mai, Thailand

Kotchaporn Intravong

Authors

Kotchaporn Intravong Chiang Dao Hospital, Thailand

Keywords:

COPD, HRQoL, 6-minute walk distance, home-based pulmonary rehabilitation, women chain of rubber bands

Abstract

Objective To determine the effectiveness of using a woven chain of rubber bands as an exercise device in home-based pulmonary rehabilitation (HBPR) in improving exercise capacity (6MWD), health-related quality of life (HRQoL) and prognosis (BODE index) in COPD patients.

Methods An 8-week randomized controlled trial (RCT) single blind (assessor blind) study was conducted with 30 COPD patients, 15 in the intervention group and 15 in the control group. All patients participating in the HBPR program were pre and post evaluated for lung function via spirometry, exercise capacity via 6MWD, HRQoL via SGRQ, and prognosis via BODE index. All scores were compared using the Paired t-Test within groups and the Independent t-Test between groups. Statistical significance was set at p<0.05.

Results Exercise using a woven chain of rubber bands for HBPR therapy improved exercise capacity
(6MWD) by 26.67±39.20 meters (p<0.01), SGRQ score (impact domain) by -19.41±14.13 points (p<0.04) and BODE index score by -0.06±16.68 points (p<0.03) compared to the control group in which both 6MWD and BODE index declined.

Conclusion HBPR using a woven chain of rubber bands is effective in improving exercise capacity (6MWD), health related quality of life (SGRQ), and disease prognosis (BODE index) in COPD patients. The model regime used in this study is practical and is likely to be complied with. HBPR using a woven chain of rubber bands is easy to access and helps eliminate the need to travel to an exercise facility. Long-term results and potential problems still need to be closely monitored.

References

1. Pocket Guide to COPD Diagnosis, Management, and Prevention – (2017 Update). [Internet]. [cited 12 September 2017]. Available from: https://goldcopd.org/pocket-guide-copd-diagnosis-management-prevention-2016/.
2. Strategy and planning division of minister of public health. Mortality rate of pneumonia and other diseases in 2012 [in Thai]. [internet]. [cited 2016 Jun 09] Available from: https:// www.bps.ops.moph.go.th.
3. Kantatong T DA, Panpanich R, Sungkarat S. The asso-ciation of BODE index wit quality of life in patient with COPD in Chiang Dao destricted, Chiang Mai, Thailand. Proceeding of the 21st APSR conference Nov 12-15. Bangkok, Thailand. Spring;2016.
4. Celli BR, MacNee W, Agusti A, Anzueto A, Berg B, Buist AS, et al. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004;23:932-46.
5. Nici L, Donner C, Wouters E, Zuwallack R, Ambrosino N, Bourbeau J, et al. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med. 2006; 173:1390-413.
6. Whaley MH, Brubaker PH, Otto RM, Armstrong LE. ACSM’s guidelines for exercise testing and prescription. Philadelphia, Pa. 7th ed. Philadelphia, Pa. Lippincott Williams & Wilkins; 2006
7. Ries AL, Bauldoff GS, Carlin BW, Casaburi R, Emery CF, Mahler DA, et al. Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines. Chest. 2007;131(5 Suppl):4s-42s.
8. Puhan MA, Gimeno-Santos E, Scharplatz M, Troosters T, Walters EH, Steurer J. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2011(10): Cd005305.
9. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015(2):Cd003793.
10. Keating A, Lee A, Holland AE. What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review. Chron Respir Dis. 2011;8:89-99.
11. Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med. 2013;187:347-65.
12. Marks G RH, Guevara-Rattray E, Poulos L and Ampon R. Monitoring pulmonary rehabilitation and long-term oxygen therapy for people with chronic obstructive pulmonary disease (COPD) in Australia: a discussion paper. Australian Institute of Health and Welfare. 2013 (ACM 29).
13. Strijbos JH, Postma DS, van Altena R, Gimeno F, Koeter GH. A comparison between an outpatient hospital-based pulmonary rehabilitation program and a home-care pulmonary rehabilitation program in patients with COPD. A follow-up of 18 months. Chest. 1996;109:366-72.
14. Maltais F, Bourbeau J, Shapiro S, Lacasse Y, Perrault H, Baltzan M, et al. Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Ann Intern Med. 2008;149:869-78.
15. Tsai LL, McNamara RJ, Moddel C, Alison JA, McKenzie DK, McKeough ZJ. Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: The randomized controlled TeleR Study. Respirology. 2017;22:699-707.
16. Krabuanrat C. Elastic of life conquer disease. [in Thai] Bangkok: Grand sport group; 2007.
17. Krabuanrat C, Supaporn S. Effects of exercise with rubber chain, the matrix of nine squares and stretching on health. Journal of Faculty of Physical Education. 2014;17:45-62.
18. Sekam1 H BVRR. Effects of tai chi exercise with elastic chest wall restriction upon pulmonary function in the elderly. Kamphaengsaen Academic Journal. 2010;8:64-79.
19. Ronnarithivichai C, Thaweeboon T, Petchpansri S, Sujijantararat R, Boonchan N, Kridiborworn C. The evaluation of physical fitness before and after 9-square-table aerobic exercise and rubber ring stretching of elders in the health promotion program for the elderly. J Nurs Sci 2009;27: 68-77
20. Butcharoen J. Exercise program with elastic cycles to improve health related physical fitness. Journal of Faculty of Physical Education. 2012;15:7-13.
21. Poomsalood S, Pakulanon S. Effects of elastic exercise program on balance in the elderly. Procedding of 9th National Conference of Kasetsart University Kamphaengsaen Campus; Dec 6-7, 2012; Nakhon Pathom, Thailand: Springer; 2012.
22. Yingratanasuk T, Thongdara J, Charoenwattana S. The result of flexercise on the improvement of upper back muscle flexibility among factory workers. SSRU Graduated Studied Journal. 2015;6:101-13.
23. Chatreewatanakul B. Pulmonary rehabilitation using an elastic band with chronic obstructive pulmonary disease patients. Songklanagarind Journal of Nursing. 2017;37:153-9.
24. Nipphitta S, Jittapaiboon N. A study of two types of rubber band exercise programs to improve physical fitness among the elderly. Research report of Health Promotion Center Region 1, 2007. [in Thai]. [Internet]. [cited 2016 Jan 15] Available from: https:// www.hpc1.anamai.moph.go.th.
25. Worawudangkool S. Guidelines for current pulmonary rehabilitation program. Apheit Journal. 2012;18:159-69.
26. Kritsnakriengkrai S, Tanyong J, Jitdamrong S, Bubphaporm R, Tunsura W. A study of the efficacy of pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease. Thai Journal of Physical Therapy. 2013;35:92-101.
27. Sport Science Bureau, Department of Physical Education, Ministry of Tourism and Sports. Stretching of the muscles with sports science in athletes 2016 (in Thai). [Internet]. [cited 2016 20 Jul]. Available from: https://www.dpe.go.th/dwl-files-401891791937.
28. Department of Physical Education, Ministry of Tourism and Sports. The Thai elderly manual. Department of Physical Education style. 2017 (in Thai). [Internet]. Available from: https://www.dpe.go.th/manual-preview-392891791886.
29. Pradella CO, Belmonte GM, Maia MN, Delgado CS, Luise AP, Nascimento OA, et al. Home-Based Pulmonary Rehabilitation for Subjects With COPD: A Rando-mized Study. Respiratory care. 2015;60:526-32.
30. Guell MR, de Lucas P, Galdiz JB, Montemayor T, Rodriguez Gonzalez-Moro JM, Gorostiza A, et al. [Home vs hospital-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a Spanish
multicenter trial]. Archivos de bronconeumologia. 2008;44:512-8.
31. Mendes de Oliveira JC, Studart Leitão Filho FS, Malosa Sampaio LM, Negrinho de Oliveira AC, Hirata RP, Costa D, et al. Outpatient vs. home-based pulmonary rehabilitation in COPD: a randomized controlled trial. Multidiscip Respir Med. 2010;5:401-8.
32. Thoracic Society of Thailand under Royal Patronage; Thai Asthma Council; National Health Security Office. Health Service Practice Guideline of COPD in 2010 (in Thai).[Internet]. Available from: https://www.nhso.go.th/frontend/page-forhospital_cpg.aspx.
33. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004;350:1005-12.
34. Mason RJ VCB, Martin TR, King TE, Schraufnagel D, Murray JF, et al. Murray and Nadel’s textbook of respiratory medicine. Philadelphia: Saunders Elsevier; 2010.
35. Sarkar SK, Basuthakur S, Das SK, Das A, Das S, Choudhury S, et al. Evaluation of correlation of BODE index with health-related quality of life among patients with stable COPD attending a tertiary care hospital. Lung India. 2015;32:24-8.
36. Sarioglu N, Alpaydin AO, Coskun AS, Celik P, Ozyurt BC, Yorgancioglu A. Relationship between BODE index, quality of life and inflammatory cytokines in COPD patients. Multidiscip Respir Med. 2010;5:84-91.