Article Text


Pulmonary rehabilitation
P46 Effects of physical activity top up ‘PAT on the back’ programme on exercise capacity and healthcare utilisation for people with chronic obstructive pulmonary disease (COPD)
  1. G Arbane1,
  2. A Douiri2,
  3. L Enright2,
  4. L Haggis2,
  5. T Poulter3,
  6. R Garrod2
  1. 1St George's University of London, London, UK
  2. 2King's College, London, UK
  3. 3Wandsworth Primary Care Trust, London, UK


Introduction Pulmonary rehabilitation (PR) is a proven effective treatment, however benefits tend to decline between 6 and 12 months post rehabilitation. Randomised controlled trials of maintenance programmes show little effect of supervised maintenance after PR However, a short intense bout of physical training, provided post rehabilitation may be sufficient to restore exercise tolerance. This study tests the hypothesis that a Physical Activity Top up programme (PAT on the back) will result in improvements in exercise tolerance as compared with no top up.

Methods 31 patients with stable COPD, who had undertaken Pulmonary rehabilitation (PR) at least 6 months previously were randomised to 4 weeks of PAT exercise once weekly or usual care. Incremental Shuttle Walk Test (ISWT) data were collected pre PAT (T1), post PAT (T2) and 3 months end of PAT programme (T3). QoL (SGRQ) and breathlessness (LCADL) were measured at the same time points. Generalised estimating equation (GEE) regression models and univariate analysis of variance were used to analyse data where subjects performed all assessments and ISWT results from end PR was used as covariate, with ISWT as dependant variable.

Results 23 subjects completed all assessments. The intervention group increases 0.9 m for every 1 m increase achieved at T1, p=0.027. The intervention group shows an overall improvement of 47.3 m, with an average increase of 17.26 m per time point. A significant time effect (p = 0.02) mean difference (SD) T1–T3 in control group showed the intervention group were 79.6 m improved with CI 15 to 143.8. There was no group or time effect for QoL or LCADL (Abstract P46 Figure 1).

Conclusion A brief 4 week intervention ‘PAT on the back’ did little to change QoL or breathlessness but was effective in maintaining exercise tolerance over a 3 month period compared to usual care in which walking distance significantly deteriorated.

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