Meta- analysis revealed few clinical ly relevant and statistically significant benefits of " add-on " therapies on exercise performance compared with exercise training .
The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease ( COPD ) .
Randomized controlled trial of domiciliary noninvasive positive pressure ventilation and physical training in severe chronic obstructive pulmonary disease.
The addition of noninvasive positive pressure ventilation ( NPPV ) to an exercise training ( ET ) program in severe chronic obstructive pulmonary disease ( COPD ) may produce greater benefits in exercise tolerance and quality of life than after training alone . Forty-five patients with severe stable COPD -mean ( SD ) FEV(1 ) 0.96 ( 0.31 ) L , Pa(O(2 ) ) 65.4 ( 9.07 ) mm Hg , Pa(CO(2 ) ) 45.6 ( 7.89 ) mm Hg-were r and omized to domiciliary NPPV + ET ( n = 23 ) or ET alone ( n = 22 ) . Exercise capacity and health status were assessed at baseline and after an 8-wk training program . There was a significant improvement in mean shuttle walk test ( SWT ) in the NPPV + ET group : from 169 ( 112 ) to 269 ( 124 ) m ( p = 0.001 ) , compared with the ET group : 205 ( 100 ) to 233 ( 123 ) m ( p = 0.19 ) ; mean difference ( 95 % confidence interval [ CI ] ) : 72 ( 12.9 to 131 ) m. Repeated measures analysis of variance ( ANOVA ) showed that the differences between the two groups became evident only in the final 4 wk of the training program with a mean end study difference ( 95 % 1CI ) of 65.8 ( 17.1 to 114 ) m. There was a significant improvement in the Chronic Respiratory Disease Question naire ( CRDQ ) of mean ( SD ) 24.0 ( 17.4 ) ( p = < 0.001 ) in the NPPV + ET group and 11.8 ( 15.8 ) ( p = 0.003 ) points in the ET group ; mean difference : 12.3 ( 1.19 to 23.4 ) . Only the NPPV + ET group demonstrated a significant improvement in arterial oxygenation ; mean difference : 3.70 mm Hg ( 0.37 to 7.27 ) . This study suggests that domiciliary NPPV can be used successfully to augment the effects of rehabilitation in severe COPD
Meta- analysis revealed few clinical ly relevant and statistically significant benefits of " add-on " therapies on exercise performance compared with exercise training .
The aim of this review was to identify the effectiveness of therapies added on to conventional exercise training to maximise exercise capacity in patients with chronic obstructive pulmonary disease ( COPD ) .