Effect Aerobic Exercise in Chronic Obstructive Pulmonary Disease to Quality of life using St George’s Respiratory Questionnaire

Pengaruh latihan erobik pada penyakit paru obstruksi kronik terhadap kualitas hidup dengan menggunakan St George’s Respiratory Questionnaire

Satryo Waspodo*, Tri Damiati Panji*, Nury Nusdwinuringtyas**, Hadyana Sukandar*

ABSTRACT

Objectives : The aim of this study was to find out an aerobic exercise program and its influence for the improvement of a quality of life and a maximum capacity of this exercise for COPD patients

Subjects : There were 60 COPD patients from the Pulmonology Department Hasan Sadikin Hospital who were eligible for this study. They were divided into two groups. The first group, called the exercised group, consisted of 30 people and the second group, called the controlled group, consisted of 30 people. During randomization process, they were only 55 people who joint the study because 5 people from the controlled group absent. Then, during the aerobic exercise, they were 3 people from the exercised group drop out. Therefore, they were only 25 people from the controlled group and 27 people from the exercised group who could accomplish until the final study (total 52 people)

Methods : This study was quasi experiment with pre and post intervention to the exercised and controlled groups. The study consist of preliminary examination for subject selection, subjects who were eligible for this study was divided into exercised and controlled groups. For the exercised group, there was SGRQ assessment with exercised test in order to assess an aerobic maximum capacity. Then, there was aerobic exercise program 3 times a week, 24 minutes duration, intensity 50-80% an aerobic maximum capacity for core exercise during 6 weeks. After 6 weeks, there was a SGRQ re-assessment and an aerobic maximum capacity. For the controlled group, there was a SGRQ re-assessment without treatment and after 6 weeks, there was a SGRA re-assessment

Setting : This study was carried out at Physical Medicine and Rehabilitation Medical Department Hasan Sadikin Hospital.

Results : For the exercised group; there was a significant decrease of SGRQ value at all components (symptoms, activity, impacts and total, P<0,001), p="0,648" p="0,055)," p="0,038)" p="0,022)." r="0,032" p ="0,873," style=""> r=-0,260 ; p =0,191, impacts r=-0,353 p =0,071 and total r=-0,303; p =0,124)

Conclusion : Aerobic exercise had an influence on the improvement of quality of life (a significant decrease of SGRQ value ) and aerobic maximum capacity for COPD patients. There was no significant correlation among the changes of quality of life (the changes of SGRQ value) with the improvement of aerobic maximum capacity

Key words : COPD, SGRQ value, Quality of Life, Aerobic Exercise.

*Dept. Physical medicine and Rehabilitation, Hasan Sadikin Hospital, Bandung - Indonesia

**Dept. Physical Medicine and Rehabilitation, Cipto Mangunkusumo Hospital, Jakarta –Indonesia

Correlation between St George’s Respiratory Questionnaire (SGRQ) and Six Minutes Walk Test (6- MWD) in COPD

Correlation between Quality Of Life in Chronic Obstructive Pulmonary Disease (COPD) Patients using St George’s Respiratory Questionnaire (SGRQ) and Functional Capacity using Six Minutes Walk Test (6- MWD)

Gunawan Kurniadi*, Nury Nusdwinuringtas*, Anita Ratnawati**

*Cipto Mangunkusumo Hospital, Jakarta- Indonesia

** Persahabatna Hospital, Jakarta-Indonesia

Abstract

Objective: This study was to assess whether Indonesian version of St George’s Respiratory Questionnaire (SGRQ) could serve as a practical outcome measure for medical rehabilitation of chronic obstructive pulmonary disease (COPD) .

Method: This was designed as correlation study . Spearmen’s rank correlation test, test-retest reliability, internal consistency Cronbach α were used for analysis.

Setting: This study was conducted at RSUPN-CM and RSUP Persahabatan.

Participated: 22 subjects suffering from COPD identified as stated in inclusion criteria.

Results : There are strong correlation between SGRQ subcales with 6 minutes walking distance test (r = - 0.49 for activity, r= - 0.58 for impacts, r= - 0.58 for total ); and moderately strong correlation with FEV 1 % prediction (r = - 0.46 for activity , r = - 0.43 for impacts, r = - 0.52 for total ). Strong correlation is also found in repeated test of SGRQ ( r= 0.76 for symptoms, r= 0.58 for activity , r= 0.51 for impacts, r= 0.58 for total). There is no significant difference among subscales except for total scores p= 0.049 in Wilcoxon test . internal consistency using Cronbach α ranged from 0.73 to o.83.

Conclusion : Activity and impacts subscales of SGRQ are proved to be valid of functional capacity and severity of lung obstruction . SGRQ is also repeatable and has high internal consistency.

Keywords : St George’s Respiratory Questionnaire (SGRQ), chronic obstructive pulmonary disease (COPD), quality of life, functional capacity

Physical Medicine and Rehabilitation , Fakulty Medicine – University of Indonesia, Jakarta – Indonesia; 2002

Effects of respiratory muscle training on Chronic Obstructive Pulmonary Disease (COPD) at the Instalation of Rehabilitation Medicine ,

xxv + 133 pages + 44 tables + 8 pictures , 1 appendices

Abstract

The purpose of this study was to examine the efficacy of targeted respiratory muscle training in patient with Chronic Obstructive Pulmonary Disease (COPD) . The study was conducted using descriptive-analytic method. The descriptive method would result in information related to any dependent and independent variable. The analytical method of randomized clinical trial based the study of the effect of respiratory muscle training. A random allocation was done resulted in eight patients with COPD belonged the breathing exercise group, eight patients received general exercises reconditioning. The other seven patients with COPD belonged to a control group with no intervention and without random allocation.

The respiration group underwent diaphragmatic breathing exercise + pursed lip breathing (PLB) . Breathing exercise were done daily at home an three times a week, under supervision at the Installation of Rehabilitation Medicine, dr Cipto Mangunkusumo hospital. The reconditioning group received exercises with ergocycle, three times a week which lasted for eight weeks under supervision at the institution.

The method analysis was done as follows : Univariat analysis was conducted to study the frequency characteristic of groups. Bivariat analysis ( paired-t test, Wilcoxon tesr) was conducted to study the effect of intervention.

Result of the study were as follows: The respiration group showed increased expiration muscle strength (MEP) significantly (p<> 0.05) and walking ability increased significantly (p <> 0.05) , physical fitness (VO ₂ max) increased (p> 0/05) . in the control group decrease of respiratory muscle strength was observed almost significantly (p > 0.05). The inspiratory muscle strength did not show result as expected, but decreased insignificantly in both groups with intervention and increased in the control group (p> 0.05).

The conclusion of the study were as follows. Breathing exercises and reconditioning resulted in better quality of life as shown by increase in walking ability . both successes derived of different approaches breathing exercise group by increases of expiratory muscle strength resulted in decrease of dyspnea and increase in quality of life. On the other side , reconditioning group resulted in better physical fitness and to better quality of life . respiratory muscle training was recommended when the exercises were intended to control dyspnea and reconditioning was done and reconditioning was done if physical fitness was intended.

We have to be aware of the increase of airway resistance in the diaphragmatic breathing exercises group + PLB . In the reconditioning group insspite of most decrease of residual air, there were decrease of inspiratory muscle strength.

Key words: Diaphragmatic breathing exercise; PLB (Pursed Lip Breathing)[ MEP (Maximal Expiratory Pressure); MIP (Maximal Inspiratory Pressure) ; dyspnea; VO₂ maximum; 12 minutes walk.

References : 67 (1962 - 1999)