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 ) .
Combining triple therapy and pulmonary rehabilitation in patients with advanced COPD: a pilot study.
BACKGROUND The synergistic interactions between pharmacotherapy and pulmonary rehabilitation has been provided , but it remains to be established whether this may also apply to more severe patients . OBJECTIVES We have examined whether tiotropium enhances the effects of exercise training in patients with advanced COPD ( FEV(1)</=60 % predicted , hypoxemia at rest corrected with oxygen supplementation , and limitations of physical activity ) . METHODS We enrolled 22 patients that were r and omised to tiotropium 18mug or placebo inhalation capsules taken once daily . Both groups ( 11 patients in each group ) underwent an in patient pulmonary rehabilitation program and were under regular treatment with salmeterol/fluticasone twice daily . Each rehabilitation session was held 5 days per week ( 3h/day ) for a total of 4 weeks . RESULTS Compared to placebo , tiotropium had larger impact on pulmonary function ( FEV(1)+0.164L , FVC + 0.112L , RV -0.544L after tiotropium , FEV(1)+0.084L , FVC -0.039L , RV -0.036L after placebo ) . The addition of tiotropium allowed a longer distance walked in 6min ( 82.3 m vs. 67.7 m after placebo ) and reduced dyspnoea ( Borg score ) ( -0.4 vs. + 0.18 after placebo ) when compared with baseline ( pre pulmonary rehabilitation program ) . The changes in SGRQ from baseline to the end of treatment were : total score -28.3U , activity -27.8U , impact -14.5U , and symptoms -33.4U in the placebo group ; and total score -19.1U , activity -18.9U , impact -16.4U , and symptoms -33.8U in the tiotropium group . CONCLUSIONS Our study clearly indicates that there is an advantage in combining pulmonary rehabilitation with an aggressive drug therapy in more severe patients
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 ) .