An evaluation of activity tolerance, patient-reported outcomes and satisfaction with the effectiveness of pulmonary daoyin on patients with chronic obstructive pulmonary disease

Abstract

Hai-long Zhang,1,2 Jian-sheng Li,1,3 Xue-qing Yu,1,2 Su-yun Li,1,2 Upur Halmurat,4 Yang Xie,1,2 Yan-fang Wang,1,2 Feng-sen Li,5 Ming-hang Wang1,2 1Collaborative Innovation Center for Respiratory Disease Diagnosis and Treatment and Chinese Medicine Development of Henan Province, Henan University of Traditional Chinese Medicine, Zhengzhou, People’s Republic of China; 2Department of Respiratory, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, People’s Republic of China; 3The Geriatric Department, Henan University of Traditional Chinese Medicine, Zhengzhou, People’s Republic of China; 4Department of Traditional Uygur Medicine, Xinjiang Medical University, Urumqi, People’s Republic of China; 5Laboratory of Pulmonary Physiology and Pathology, Traditional Chinese Medicine Hospital affiliated with Xinjiang Medical University, Urumqi, People’s Republic of China Background and objective: Pulmonary Daoyin (PD) (evolved from ancient Chinese daoyin skills), is a rehabilitation technology that combines specially designed movements of the arms and body and controlled breathing exercises, to improve the physiological and psychological status of patients with chronic respiratory disease. Pulmonary rehabilitation is effective for patients with chronic obstructive pulmonary disease (COPD), and the efficacy of PD is unknown. The aim of this study is to investigate the effect of a PD program in enhancing activity tolerance, patient-reported outcomes and satisfaction with the effectiveness on patients with COPD. Materials and methods: The multi-center, randomized controlled trial was conducted from November 2011 to June 2012 in local communities in cities of the 11 research centers in China. It included COPD patients (moderate to very severe) who were recruited from an outpatient clinic. A randomized controlled study included 464 COPD patients who were randomly allocated either to the PD group, participating in a 3-month, ten times-weekly supervised PD-based pulmonary rehabilitation program, or to a control group continuing with regular medical treatment alone. Data were gathered using the 6-minute walking distance (6MWD) test, COPD patient-reported outcomes (COPD-PRO) and Effectiveness Satisfaction Questionnaire for COPD (ESQ-COPD), which was filled out at baseline and 3 months post-intervention. SAS 9.2 was used for statistical analysis.Results: Of the 464 patients in the study, 461 were included in the full analysis set (FAS); 429 were in the per-protocol analysis set (PPS). After 3-month intervention, there was a significant difference between the two groups in 6MWD (FAS; P=0.049; PPS; P=0.041), total score and all domains of COPD-PRO (FAS; P=0.014; PPS; P=0.003) and ESQ-COPD (FAS; P=0.038; PPS; P<0.001).Conclusions: The PD program was able to improve the activity tolerance level and satisfaction of COPD patients because of its effectiveness. Keywords: chronic obstructive pulmonary disease, pulmonary rehabilitation, pulmonary daoyin, patient reported outcomes, effectiveness satisfaction, 6-minute walking distance

Keywords

• Chronic Obstructive Pulmonary Disease
• Pulmonary rehabilitation
• Pulmonary Daoyin
• Patient reported outcomes
• Effectiveness satisfaction
• 6-minute walking distance.