The Effects of a Home Exercise Video Programme for Patients With COPD

Pulmonary Rehabilitation (PR) has been shown to deliver cost-effective improvements in dyspnoea, exercise tolerance and health-related quality of life (HRQoL) in people with chronic obstructive pulmonary disease (COPD). PR programmes in the United Kingdom (UK) are typically delivered on an outpatient basis, either at a hospital or suitable site in the community. It is not always possible however, for patients to access outpatient programmes due to lack of local availability or adequate transport from isolated locations. Severe breathlessness may reduce activity levels to such a degree that for many leaving the house is an ordeal. A British Lung Foundation (BLF) survey reported that less than 2% of UK COPD patients had access to a rehabilitation exercise programme, despite National Institute for Health and Clinical Excellence (NICE) and British Thoracic Society (BTS) recommendations that PR be made available to all patients who are functionally limited by dyspnoea. Meeting the demand for PR remains a challenge.

Access to the benefits of PR may be broadened if effective exercise could be administered at home. Current evidence suggests that home-based rehabilitation interventions result in smaller benefits as judged by exercise tolerance and quality of life when compared to supervised programmes. The impact of home based rehabilitation may be limited by multiple factors including, lack of health care professional supervision and lack of support from fellow COPD sufferers. This lack of support may lead to poor adherence to prescribed exercise intensity and frequency in home programmes.

One-to-one supervision on an individual basis is unlikely to be feasible or cost-effective, however, use of a home exercise video could enhance adherence to prescribed exercise programmes. Video media can be an effective means of delivering exercise instruction. No published research to date has investigated the effectiveness of a home exercise video for patients with COPD. We hypothesised that an exercise programme based on video instruction at home, could improve walking ability, breathlessness and quality of life.

Inclusion criteria

• Moderate/severe COPD
• Access to a video or DVD player

Exclusion criteria

• Comorbid condition that precludes safe exercise
• Previous attendance at a pulmonary rehabilitation programme