Effectiveness of Paced Walking to Music at Home for Patients with COPD

Figures & data

Figure 1.  CONSORT flow diagram of patient recruitment and retention.

Table 1.  Characteristics of the study subjects at baseline

Variables	Experimental (n = 20)	Control (n = 21) n (%)
Sex
Male	19 (95.0)	20 (95.2)
Female	1 (5.0)	1 (4.8)
	Mean ± SD	Mean ± SD	95% C.I
Age	73.1 ± 11.2	75.1 ± 9.6	–4.6 ∼ 8.5
BMI	24.7 ± 3.8	23.6 ± 3.6	–3.5 ∼ 1.2
Smoking(packs/year)	41.9 ± 45.9	37.1 ± 36.3	–30.9 ∼ 21.2
Yrs since quitting smoking	10.8 ± 13.6	6.8 ± 9.1	–11.5 ∼ 3.4
Yrs since COPD diagnosis	7.1 ± 5.7	7.5 ± 5.4	–3.1 ∼ 3.9
GDS	1.7 ± 2.3	2.2 ± 9.4	–1.0 ∼ 2.0
SPMSQ	1.0 ± 0	1.0 ± 0

BMI: body mass index.

GDS: Geriatric Depression Scale

SPMSQ: Short Portable Mental Status Questionnaire

*p < 0.05, **p < 0.01, ***p < 0.001.

Table 2.  Mean ± SD of outcome variables at baseline

Outcome Variables	Experimental (n = 20) Mean ± SD	Control(n = 21) Mean ± SD	95% C.I
Exercise capacity
Distance of ISWT (m)	243.5 ± 135.4	237.6 ± 124.4	–87.9 ∼ 76.2
PRE-D	2.2 ± 1.3	1.4 ± 1. 6	–1.7 ∼ 0.1
PRE-L	1.2 ± 1.4	1.0 ± 1.3	–1.1 ∼ 0.6
Heart rate (bpm)	84.1 ± 12.9	88.7 ± 13.5	–3.7 ∼ 12.9
SpO2	95.1 ± 1.9	96.0 ± 1.9	–0.3 ∼ 2.1
Pulmonary function
FEV1 (L)	1.4 ± 0.6	1.2 ± 0.5	–5.2 ∼ 0.2
FVC (L)	2.3 ± 0.9	2.0 ± 0.5	–0.9 ∼ 0.1
FEV1/FVC (%)	59.3 ± 6.7	61.6 ± 8.4	–2.5 ∼ 7.2
FE V1% predicted	60.6 ± 18.9	61.2 ± 26.3	–13.8 ∼ 15.2
Quality of life
Symptom	33.3 ± 21.0	27.5 ± 21.7	–21.1 ∼ 5.2
Activity	45.2 ± 14.9	44.8 ± 20.0	–11.6 ∼ 10.8
Impact	22.7 ± 18.1	18.4 ± 15.2	–14.8 ∼ 6.2
Total	31.6 ± 14.4	27.9 ± 15.7	–13.2 ∼ 5.8
Health care utilization
Hospital frequency	0.0 ± 0.0	0.1 ± 0.2	–0.1 ∼ 0.1
Hospital days	0.0 ± 0.0	0.2 ± 0.9	–0.2 ∼ 0.6
Emergency frequency	0.0 ± 0.0	0.1 ± 0.2	–0.1 ∼ 0.1

ISWT: incremental shuttle walk test; SpO2: oxygen saturation by pulse oximetry; FEV1/FVC: forced expiratory volume in 1 second/ forced vital capacity; FEV1% predicted: prediction of forced expiratory volume in 1 second.*p < 0.05, **p < 0.01, ***p < 0.001.

Figure 2.  The mean values for the walking distance (m) of the incremental shuttle walking test at visits at baseline to 16 weeks. *p < 0.05, **p < 0 .01, ***p < 0.001Notes: The home pacing group increased from 243.5 ± 135.4 at baseline to 4 weeks (285.5 ± 136.2, x2 = 13.3, p < 0.001), 8 weeks (288.4 ± 136.2, x2 = 73.7, p < 0.001), 12 weeks (280.6 ± 139.1, x2 = 99.6, p < 0.001), and 16 weeks (306.0 ± 107.3, x2 = 40.1, p < 0.001) compared to the control group means of 237.6 ± 124.4, 204.3 ± 96.4, 206.4 ± 102.8, 209.9 ± 11.2, 218.47 ± 119.41 across the 5 visits.

Figure 3.  The mean values for Borg RPE-D (3a) and Borg RPE-L (3b) at visits at baseline to 16 weeks. *p < 0.05, **p < 0.01, ***p < 0.001.

Table 3.  Health care utilization during the 4 months study period

Variables	Case (n = 20)Mean ± SD	Control (n = 21) Mean ± SD	t	P
Hospital frequency	0.03 ± 0.2	0.04 ± 0.2	0.81	0.11
Hospital days	0.2 ± 1.4	0.3 ± 1.3	0.26	0.64
ER frequency	0.03 ± 0.2	0.04 ± 0.3	0.31	0.52
Unscheduled clinic visits	0.03 ± 0.2	0.0 ± 0.0	–1.75	0.001

*p < 0.05, **p < 0.01, ***p < 0.001.

Table 4.  Mean values for SGRQ scores at visits baseline to 16 weeks and GEE analysis to verify the effectiveness of home-based exercise

	Experimental		GEE
Outcome variables	Mean±SD	Control Mean±SD	Parameter	B	95% CI	X2
Symptom			(Intercept)	5.6	–10.1 ∼ 53.2	1.8
Weeks 1	35.4 ± 20.5	27.5 ± 21.1	Case vs. Control	9.7	–1.8 ∼ –21.3	2.8
Weeks 4	29.3 ± 19.0	36.7 ± 25.3	group X Weeks 4	–17.5	–27.2 ∼ –4.2	7.2**
Weeks 8	18.1 ± 12.1	36.4 ± 24.0	group X Weeks 8	–25.3	–36.5 ∼ –14.2	19.7***
Weeks 12	17.1 ± 13.7	30.8 ± 24.7	group X Weeks 12	–22.5	–36.2 ∼ –8.8	10.4**
Weeks 16	14.5 ± 9.6	24.7 ± 20.5	group X Weeks 16	–21.2	–34.8 ∼ –7.6	9.4**
Activity			(Intercept)	–1.2	–32.6 ∼ 30.2	0.0
Weeks 1	45.2 ± 14.9	44.8 ± 20.0	Case vs. Control	2.7	6.3 ∼ 11.6	0.3
Weeks 4	42. 9 ± 18.2	49.9 ± 25.0	group X Weeks 4	–7.6	–15.7 ∼ –0.49	3.4
Weeks 8	37.0 ± 16.8	53.9 ± 23.5	group X Weeks 8	–15.9	–24.3 ∼ –7.41	13.4***
Weeks 12	36.2 ± 19.5	57.0 ± 24.9	group X Weeks 12	–21.6	–32.8 ∼ –10.4	14.3***
Weeks 16	34.5 ± 8.4	52.7 ± 24.2	group X Weeks 16	–20.4	–8.3 ∼ –10.9	10.9**
Impact			(Intercept)	2.3	–29.4 ∼ 34.1	10.9
Weeks 1	22.7 ± 18.1	18.4 ± 15.2	Case vs. Control	6.0	–3.6 ∼ 15.6	1.5
Weeks 4	16.4 ± 12.2	23.0 ± 19.0	group X Weeks 4	–11.0	–18.3 ∼ –3.8	8.9**
Weeks 8	12.0 ± 12.3	25.3 ± 19.2	group X Weeks 8	–16.9	–25.3 ∼ –8.5	15.5***
Weeks 12	9.7 ± 13.1	24.3 ± 17.7	group X Weeks 12	–20.6	–30.2 ∼ –10.9	17.4***
Weeks 16	10.2 ± 13.5	21.7 ± 15.0	group X Weeks 16	–18.2	–26.9 ∼ –9.6	17.0***
Total			(Intercept)	2.3	–29.4 ∼ 34.1	0.0
Weeks 1	31.6 ± 14.4	27.9 ± 15.7	Case vs. Control	6.0	–3.6 ∼ 15.6	1.5
Weeks 4	26.6 ± 10.9	33.4 ± 20.0	group X Weeks 4	–11.0	–18.3 ∼ –3.8	8.9**
Weeks 8	20.4 ± 11.2	35.8 ± 19.4	group X Weeks 8	–16.9	–25.3 ∼ –8.5	15.5***
Weeks 12	19.0 ± 12.2	35.3 ± 19.7	group X Weeks 12	–20.6	–30.2 ∼ –10.9	17.4***
Weeks 16	18.3 ± 12.7	31.6 ± 16.3	group X Weeks 16	–18.2	–26.9 ∼ –9.6	17.0***

Weeks 1, 4, 8, 12, 16 case number of experimental/control: 20/21, 20/21, 19/20, 17/16, 15/15; *p < 0..05, **p < 0..01, ***p < 0.001