Stationary bicycle training at home in COPD patient on LTOT. Is it enough to improve quality of life and exercise capacity? A pilot study

Pulmonary rehabilitation improves quality of life (QoL) and exercise capacity (EC) in COPD patients. LTOT with stationary source may reduce daily activities (DA). Aim of study was to assess if self administered training at home improves QoL, EC and overcomes restriction in DA. Methods: Consecutive COPD pts qualified for LTOT with oxygen concentrator were assessed and randomly assigned to training (TG) or control (CG) groups. Assessment comprised of: cardiopulmonary exercise test (CPET) on cycle ergometer, 6 minute walk test (6MWT), dyspnoea (MRC scale), lung function tests, QoL (SGRQ), DA measured by actigraphy and questionnaire. Training consisted of 30 min. cycling every day for 3 months. In TG adherence to training and its performance was verified by memory card, pts were regularly visited and load was adjusted to patients ability. CG was monitored by phone and encouraged to sustain physical activity. Results: We studied 33 pts (18M, 15F), mean age 70±9 yrs, mean FEV1 0.9±0.4 l (40±13%), mean PaO2 55±4 mmHg. Of 20 pts allocated to TG, 13 pts completed training program. Adherence was satisfactory, pts trained 73±23% of days. TG showed significant improvement in SGRQ (symptoms) and duration of CPET. There was tendency to improve VO2max (p=0.054) and total SGRQ score (p=0.07). Better adherence to training correlated with greater improvement in QoL, VO2max and 6MWT distance. Higher work load reached during training correlated with reduction in MRC scale and improvement in 6MWT distance and VO2max. Conclusions: Self cycling at home may improve QoL and EC in COPD patients starting LTOT with stationary source, but has no effect on performance of DA.