DPA has been evaluated by pedometry in the case of 74 patients (men) with stable COPD, without significant associated pathology and without physical limitations, aged 63.55±8.73 (12 stage II, FEV1 =60.16±7.78%), (29 stage III, FEV1=39.07±6.30%), (33 stage IV, FEV1 =23.1±7.18%). These patients were monitored for a period of 7 days. The test was done before and after 6 months of Pulmonary Rehabilitation Programs (PRP) of 3 weeks (Tables and ).
Characteristics of the three groups of patients COPD
Results of monitoring the daily physical activity by pedometry
We split our patients in this group after spirometry, taking into consideration the GOLD guideline 2009. Initially, each patient had to do spirometry, 6-MWT and SGQ. Then they had to wear a Canyon pedometer during the entire day, every day for a week and had to note the numbers of steps/24 hours and some comments. The week log contains patient data (name, age, gender), weight, height, body mass index, profession, origin (urban or rural), starting day (season), steps/day and comments on physical training, spending leisure time and weather. They all had to undertake a PRP for three weeks. Included in the program were the following aims: understanding the disease, helping patients to give up smoking, cough and sputum education, adapted diet and physical training with the purpose of stimulating the respiratory and periferic muscles. The rehab program was carried out in the Department of Pulmonary Rehabilitation of the Victor Babes Clinical Hospital of Timisoara on inpatients for 3 weeks (the duration was approved by the Romanian Health Authorities). Patients followed sessions of daily training 5 day/week under the supervision of physiokinotherapists. The physical effort was individualized for each patient, according to the severity of the disease, age, BMI, and the pre-existent physical condition. At the beginning the duration and the intensity of the effort was low (15–20 minutes of the 70% of the functional capacity). These were increased every 2–3 days. In association there were film sessions, leaflets with medical education with information concerning the disease,treatment, and manner of administration, diet, risks (held by pulmonologists, psychologists, nurses in working day).
After six months, patients were re-evaluated under the same circumstances with 6-MWT, SGQ, and pedometry (Tables and ).
The results obtained to monitoring effort tolerance (6 MWT) and quality of life (SGQ)
The results obtained to monitoring effort tolerance (6MWT), quality of life (SGQ) and pedometry in control group
When released from hospital, each patient received a list with recommendations regarding physical activity (daily gymnastics, minutes to walk/run, fitness), and diet. Afterwards, a contact with the patients was made by telephone every two weeks. The nurses questioned the patients about their adherence to each chart, and encouraged them to continue the program. We wanted to stimulate them to continue their physical training and treatment as recommended.
A control group consisting of 21 patients with stable COPD (5 stage II, 7 stage III, and 9 stage IV) were evaluated initially, but they did not undergo PRP. After 6 months, they were re-evaluated using the same parameters (Table ).
The results obtained to monitoring the daily physical activity by pedometry in control group
The analysis of the results was performed by calculating the average value (VM) and the standard deviation (SD) to each group and for each parameter monitored. The Pearson (high statistical value p <0.05) test was used to establish the level of the statistically significant modifications that occurred after 6 months, and with the Beaghehole index 1997 (r<0.20 absent correlation and r≥0.70 strong correlation) the association/correlation strength of these parameters was decided upon. To evaluate the evolution of each patient we used the paired t test. To evaluate the normality of dispersion of the studied groups we used D’ Agostino test.