Keeping respiratory patients active post pulmonary rehabilitation (2016)

Our exercise research poster, displayed at the PCRS conference.

Download as a high-resolution PDF (370KB)

Aim

Due to a lack of available places for respiratory patients on existing post pulmonary rehabilitation maintenance exercise classes in Portsmouth, we secured funding from Portsmouth CCG via our Breathe Easy Portsmouth South support group to deliver 2 extra maintenance exercise classes to meet this demand.

Methods

Patients with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD) and bronchiectasis attended these classes which were delivered by Band 4 and Band 3 Physiotherapy Technicians from Solent NHS Trust.

  • 2 additional classes were delivered from March 2015 – March 2016, each providing patients with 12 sessions of exercise (one session per week).
     
  • A total of 103 different patients attended more than 1 exercise session from the 2 maintenance classes over the year.
     
  • 55 of these patients were new to the classes.
     
  • Of these 55 patients 56% of them completing 6 weeks of their 12 week course.

Results

Attendance at the maintenance exercise classes delivered either a continuation in current breathlessness levels or in the majority of cases there was an overall improvement in breathlessness levels and improved exercise tolerance.

Baseline time point at which distance walked measured Proportion of patients who improved distance walked between baseline and completion of 12 week maintenance exercise session (%)
At start of 7 week pulmonary rehabilitation programme 54
At end of 7 week pulmonary rehabilitation programme 63
At initial assessment for maintenance exercise sessions 68

We measured the impact of long term lung conditions on the patients’ lives and how this changed over attending the exercise classes via the COPD Assessment Test (CAT score), the Hospital Anxiety and Depression Score (HAD), and the Dyspnoea section of the Chronic Respiratory Disease Questionnaire (CRDQ) to measure the patients quality of life/well-being.

Score type Baseline time point at which score measured Proportion of patients who maintained or improved score between baseline and completion of 12 week maintenance exercise sessions (%)
CAT At end of 7 week pulmonary rehabilitation programme 42
CAT At start of 7 week pulmonary rehabilitation programme 63
HAD At end of 7 week pulmonary rehabilitation programme 79
CRDQ Dyspnoea At end of 7 week pulmonary rehabilitation programme 42
CRDQ Dyspnoea At end of 7 week pulmonary rehabilitation programme 92

Conclusions

I have noticed an improvement in breathing and enjoy the exercise. The staff are fun, helpful and give out great advice

The involvement and attendance of members from Breathe Easy Portsmouth South (patient self-help support group) was invaluable to the numbers of people attending and completing the classes. Breathe Easy input via peer support, encouragement and leadership was a pivotal factor in ensuring the maintenance exercise classes were fun (being breathless and exercising isn’t always fun!) and that patients continued to regularly attend the classes.

There is a real desire from the patients who have attended and benefited from pulmonary rehabilitation to be able to continue exercising in a supervised and structured environment. The findings show that all of the patients who attended the maintenance exercise classes have continued to make improvements in one or more of their outcome measures (breathlessness levels and exercise tolerance, and/or quality of life measures) demonstrating positive patient outcomes.