Results on health-related quality of life and functionality of a patient-centered self-management program in hospitalized COPD: a randomized control trial

Abstract

Objective: The main objective of this study was to evaluate the results of an in-hospital Self-Management program in addition to physiotherapy in severe patients with Chronic Obstructive Pulmonary Disease (COPD) compared to a physiotherapy program.

Methods: In this randomized clinical trial, 66 acute exacerbation COPD patients were included and were randomly divided into three groups. The Control group received standard medical treatment. The Physical therapy group received Control Group intervention plus a Physical Therapy intervention, consisting of neuromuscular stimulation therapy on the quadriceps muscle accompanied by lower limb exercises. The Self-management group received Physical Therapy group intervention plus a Self-Management program, which included educational information complemented with a problem-based session, breathing exercises and relaxation exercises. The main outcomes measured were the health-related quality of life and functionality.

Results: All treated groups show improvements in all outcomes, being significant in the case of all total scores of health-related quality of life and functionality(p < 0.05) between Physical Therapy group and Self-Management group. At 3 months, health-related quality of life shows reductions in all subscores in Control Group and Physical Therapy groups, while Self-Management group shows minimal maintenance of the values.

Conclusion: An individualized Self-Management program added to a physiotherapy program administered once a day improves health-related quality of life and functionality compared to a Physical Therapy and to a Control Group in hospitalized severe COPD patients.

Implications for rehabilitation

• Self-management is the most challenging area of chronic diseases improving patient self- efficacy and reducing cost.

• A self-management program improves health-related quality of life and functionality compared to a physical therapy treatment in severe Chronic Obstructive Pulmonary Disease hospitalized patients.

Keywords:

• Pulmonary disease
• chronic obstructive
• self-management
• physical therapy modalities
• hospital medicine
• physical therapy specialty

Disclosure statement

The authors declare that there are no conflicts of interest.

Additional information

Funding

This work was supported by the University of Granada (BecaContrato FPU 2017, Plan propio de investigación, Universidad de Granada), and financed jointly by Fundación Progreso y Salud (FPS) and Boehringer Ingelheim, Espana, SA. Project code: PI-0370–2014.