Dyspnea is the primary disabling symptom of COPD. Pulmonary rehabilitation (PR) provides exercise training, however, post PR adherence to exercise is poor. By occupying the attention channels with normally carry dyspneagenic information, distractive auditory stimuli (DAS) may reduce the perception of dyspnea, promoting increased exercise tolerance and adherence. The purpose of this study was to determine the feasibility of DAS when used with upper extremity training (UET) on perceived dyspnea, functional performance and health-related quality of life in patients with moderate to severe COPD. In addition, we attempted to validate the appropriate music tempo (moderate DAS or slow DAS) to use with UET. An experimental, randomized, 3-group design (n=10/ group) with testing at baseline and 4 weeks was used. Thirty patients (13 male, 17 female) with COPD (FEV1 41.3% + 18% predicted were enrolled. All DAS subjects were instructed to perform upper extremity training (UET) for up to 15 minutes 3 to 5 times a week using DAS (walkman, audiocassettes). The control group received the same instructions, but no DAS. Outcome measures were perceived dyspnea, functional performance using the 6-minute ring and pegboard (6MRP) count and health-related quality of life. In addition, all subjects recorded the time of UET performance using self-report (daily logs). A significant increase was seen in 6MRP count (p=0.002) between groups. Moderate DAS subjects increased 6MRP count 46 + 21 rings and slow DAS subjects increased 46 + 20 rings from baseline to 4 weeks whereas control subjects increased only 5 + 4 rings. No significant differences were noted for the remaining variables. In conclusion, subjects who used DAS (music) while performing UET improved functional performance whereas controls failed to continue improvement. DAS is a feasible adjunct to UET that may have the potential to augment the effectiveness of PR training.
Session #1173 - Physical Activity and Patient Outcomes
The 29th Annual MNRS Research Conference (April 1-4, 2005)