A simple method for home exercise training in patients with chronic obstructive pulmonary disease: one-year study.

Purpose: The success of long-term exercise training (ExT) programs resides in the integration between exercise prescription and patient compliance with home training. One of the crucial issues for the patients is the understanding of appropriate exercise intensity. We compared 2 methods of home ExT, based on walking.

Methods: Forty-seven patients with chronic obstructive pulmonary disease were recruited and underwent respiratory function, exercise capacity evaluation with a 6-minute walk test, and treadmill tests. Physical activity was monitored by a multisensor Armband (SenseWear, Body Media, Pittsburgh, PA). Patients were randomly assigned to 2 different home training methods and assessed again after 6 and 12 months; group A₁: speed walking paced by a metronome, and group A₂: walking a known distance in a fixed time.

Results: Thirty-six patients completed the study. All subjects showed a significant improvement in the 6-minute walk test after 1 year but the improvement was higher in A₁ than in A₂ (P < .05). Physical activity levels were significantly higher at T12 versus baseline only in group A₁ (P < .05).

Conclusions: The use of a metronome to maintain the rate of walking during home ExT seems to be beneficial, allowing patients to achieve and sustain the optimal exercise intensity, and resulting in greater improvement compared to simply using a fixed time interval exercise.