Tailored exercise is safe and beneficial for acutely hospitalised older adults with chronic obstructive pulmonary disease

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.