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 ) .
Effects of unsupported upper extremity exercise training in patients with COPD: a randomized clinical trial.
BACKGROUND Current guidelines on pulmonary rehabilitation ( PR ) recommend upper extremity exercise training ( UEET ) in patients with COPD . However , the literature still questions the effectiveness of systematic UEET in this population . We studied the effects of 15 sessions of unsupported UEET on functional exercise capacity , the ability to perform activities of daily living ( ADL ) , and symptoms perceived during activities involving arms in patients with COPD . METHODS We conducted a r and omized trial that consisted of 3 weeks of inpatient PR , comparing the short-term effects of unsupported UEET plus PR ( intervention group ) to those of PR alone ( control group ) . A change in the 6-min ring test ( 6MRT ) was the primary outcome ; the ADL field test ( four shuttle stations ) , the dyspnea score as assessed by the Medical Research Council scale , the London Chest Activity of Daily Living scale ( LCADL ) , and the distance walked in 6 min served as secondary outcomes of the study . At the 6-month follow-up , we repeated the 6MRT and the LCADL . RESULTS Fifty patients with COPD were r and omly assigned to the two groups and completed the study . At the end of the study period , patients in the intervention group improved in the 6MRT and ADL field test compared with those patients in the control group ( p = 0.018 and p = 0.010 , respectively ) with reduced perception of fatigue ( p < or= 0.006 ) . At the 6-month follow-up , 6MRT ( p = 0.001 ) and LCADL ( p = 0.039 ) scores were still significantly better in the intervention group compared with the control group . CONCLUSIONS Our trial corroborates the effectiveness of unsupported UEET in specifically improving functional exercise capacity of patients with COPD . Moreover , it also provides evidence that this training modality may ameliorate and maintain the patients ' autonomy over and above st and ard PR . TRIAL REGISTRATION Clinical Trials.gov Identifier : NCT00825032
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 ) .