Different types of physical training in patients with COPD: a follow-up after a resistance training and analysis of the satisfaction and adherence to a functional circuit

Author(s)

Isis Grigoletto Silva

• Document type: Master's Dissertation
• Press: Presidente Prudente. 2019-06-11.
• Institution: Universidade Estadual Paulista (Unesp). Faculdade de Ciências e Tecnologia. Presidente Prudente
• Defense date: 2019-03-21
• Advisor: Ercy Mara Cipulo Ramos

Abstract

Introduction: The physical exercise is an important component in the treatment of patients with Chronic Obstructive Pulmonary Disease (COPD). Some modalities of physical exercise are resistance training, aerobic training, and functional training. Elastic resistance training is a low-cost alternative to resistance training with conventional weight machines, and aerobic training combined with resistance training, that are the most popular approaches. Although the benefits obtained by these exercises are diminished over the time after the training finalization, another issue is the unsatisfactory training adherence of these patients due to the exercise monotony. Therefore, studies aim to identify modalities of trainings able to attract and maintain the satisfaction of these patients. Thus, verifies if a resistance training with elastic components can promote the maintenance of the gains obtained after training, in addition, to verify if the inclusion of the functional training to a habitual training can be an alternative to improve the adherence of patients with COPD. Objective: To realize two studies with the following objectives: 1) to verify if a resistance training with elastic components is able to promote the maintenance of the gains obtained by patients with COPD after the finalization of the training and 2) to verify if the inclusion of a functional training to a conventional training (aerobic and resistance) can promote better satisfaction and adherence of patients with COPD. Methods: In order to attend the first objective, 33 patients with COPD were randomized into three groups: Elastic Band training Group (EBG), Elastic Tube training Group (ETG) and training Group with Conventional weight machines (CG). Participants performed three months of intervention and three months of follow-up. The functional capacity (six-minute walk test – 6MWT), physical activity level (Baecke's questionnaire), quality of life (COPD assessment questionnaire - CAT and Mini Sleep Questionnaire - MSQ) and body composition (Bioimpedance, Octopolar InBody) was assessed before and after at the training finalization and in three months of follow-up. In order to attend the second objective, other 21 patients with COPD, not related to the first study, were divided into two groups: Functional Training Group (FTG) and Conventional Training Group (CTG), after eight weeks of training focus groups was conducted to assess the satisfaction, and participants answered quantitative questionnaires to evaluate the aspects of the training. Finally, the adherence was verified by sessions’ attendance. Results: In the first study, at three months of follow-up, was observed a maintenance in body composition (p>0.05), quality of life (p>0.05) and in the level of physical activity (p=0.98) in the groups (EBG, ETG and CG), and a decline in functional capacity, with Minimum Clinically Important Difference (MCID) on the ETG group. In the second study was observed a similar adherence (p=0.965) and satisfaction (p=0,341) in both groups (FTG and CTG). The increase in respiratory symptoms, distance from home to training centre and personal problems did not interfere in the adherence and presented no difference between groups (p> 0.05). Disease management, physical and psychosocial improvements, interpersonal relationships and proposed exercises were factors related to satisfaction. However, presence of pain, comorbidities, beliefs and personal lack of motivation interfered in the satisfaction training. Conclusion: At three months follow-up after the finalization of resistance training with elastic components, there were the maintenance in body composition, quality of life and level of physical activity of patients with COPD, however, there was a decline in functional capacity in ETG. Additionally, was verified that an insertion of functional exercises in conventional training of patients with COPD presented high satisfaction and adherence, however, similar with conventional training. (AU)

• FAPESP's process: 17/10925-2 - Acceptability and adherence to the insertion of a functional circuit to aerobic and resistance training in patients with COPD: a qualiquantitative study
• Grantee: Isis Grigoletto Silva
• Support Opportunities: Scholarships in Brazil - Master