The Effect of Walking Exercise in Patients With Chronic Obstructive Pulmonary Disease

Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation68 enrolled

Overview

"Patients were divided into two groups: the experimental group (E group) and the control group (C group). The E group received standard care, walking exercise, and elastic band exercise, and wore a smart bracelet to record walking steps and sleep for three months. During the first month, participants performed walking exercise for 100 minutes per week and used a red elastic band for resistance training. In the second month, walking exercise increased to 150 minutes per week with a green elastic band. In the third month, walking exercise increased to 150-300 minutes per week with a blue elastic band. The C group wore the smart bracelet to record walking steps and sleep for three months. Each group included 34 participants. The study was conducted from September 9, 2021, to December 31, 2025. Exclusion criteria included panic disorder, cognitive impairment, current cancer treatment, angina pectoris or myocardial infarction within the past 3 months, participation in high-intensity rehabilitation exercise, and walking dysfunction. Participants were required to follow the study protocol. * Assessments\*\*: * Anxiety and Depression\*\*:Measured using the Chinese version of the Hospital Anxiety and Depression Scale (HADS). * Dyspnea\*\*:Measured using the Modified Medical Research Council (mMRC) scale. * Life and Sleep quality\*\*:Measured using the COPD Assessment Test (CAT) and Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI).

Patients will be divided into two groups: the experimental group (E group) and the control group (C group). The E group will receive standard care, walking exercise, and elastic band exercise, and will wear a smart bracelet to record walking steps and sleep for three months. During the first month, participants will perform walking exercise for 100 minutes per week and use a red elastic band for resistance training. In the second month, walking exercise will increase to 150 minutes per week with a green elastic band. In the third month, walking exercise will increase to 150-300 minutes per week with a blue elastic band. The C group will wear a smart bracelet to record walking steps and sleep for three months. Each group will enroll 34 participants. The study period is from September 9, 2021, to December 31, 2025. Participants with contraindications such as panic disorder, cognitive impairment, ongoing cancer treatment, angina pectoris or myocardial infarction within the past 3 months, participation in high-intensity rehabilitation exercise, or walking dysfunction will be excluded at enrollment based on the exclusion criteria. Participants are required to follow the study protocol.

Study Type

Interventions

Elastic bandDEVICE

Thera-Band® elastic band exercise protocol: First stage (weeks 1-4): Participants performed leg resistance stretching exercises with a red elastic band. In weeks 1-2, exercises were performed 3 times per week, with 2 sets per session; in weeks 3-4, 3 times per week, with 3 sets per session. Second stage (weeks 5-8): Participants performed leg resistance stretching exercises with a green elastic band. In weeks 5-6, exercises were performed 3 times per week, with 2 sets per session; in weeks 7-8, 3 times per week, with 3 sets per session. Third stage (weeks 9-12): Participants performed leg resistance stretching exercises with a blue elastic band. In weeks 9-10, exercises were performed 3 times per week, with 2 sets per session; in weeks 11-12, 3 times per week, with 3 sets per session.

Xiaomi Mi Band 4 wearable deviceDEVICE

The Xiaomi Mi Band 4 wearable device has been certified by the National Communications Commission (Certification No. CCAG19LP0080T6). From weeks 1 to 12, participants' daily walking steps were monitored using the Xiaomi Mi Band 4 wearable device.

WalkingBEHAVIORAL

Walking exercise plan

Eligibility

Sex: ALLMin age: 40 YearsMax age: 100 Years

Medical Language ↔ Plain English

Participants were recruited according to the following criteria. Inclusion Criteria: * Inpatients diagnosed with chronic obstructive pulmonary disease (COPD) according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. * Age ≥ 40 years. * Post-bronchodilator FEV₁/FVC ratio \< 70%. * History of smoking. * Ability to perform walking exercises. * Willingness of the patient or a family member to provide written informed consent. Exclusion Criteria: * Panic disorder. * Presence of delirium with inability to cooperate. * Currently receiving cancer treatment. * Angina pectoris or myocardial infarction within the past 3 months. * Currently undergoing high-intensity rehabilitation exercises.

Outcomes

Primary Outcomes

Hospital Anxiety and Depression Scale (HADS)

HADS was used to assess differences between groups and over time. The questionnaire consists of 14 items: 7 for anxiety and 7 for depression. Scores range from 0 to 21 for each subscale, with higher scores indicating greater levels of anxiety and depression.

Time frame: Patients were assessed before discharge as the baseline, and reassessed at 4, 8, and 12 weeks post-discharge.

modified Medical Research Council (mMRC)

The mMRC scale was used to assess differences in dyspnea severity between groups over time. The mMRC is a five-point scale ranging from 0 (least severe) to 4 (most severe), with higher scores indicating greater dyspnea severity.

Time frame: Patients were assessed before discharge as the baseline, and reassessed at 4, 8, and 12 weeks post-discharge.

COPD Assessment Test (CAT)

The COPD Assessment Test (CAT) was used to assess differences between groups over time. The CAT consists of 8 items scored from 0 to 5, yielding a total score of 0 to 40, with higher scores indicating a greater impact of COPD on quality of life.

Time frame: Patients were assessed before discharge as the baseline, and reassessed at 4, 8, and 12 weeks post-discharge.

Chinese Version of the Pittsburgh Sleep Quality Index (CPSQI)

CPSQI was used to assess differences between groups over time. Scores range from 0 to 21, with higher scores indicating poorer sleep quality. A score greater than 5 denotes poor sleep quality.

Time frame: Patients were assessed before discharge as the baseline, and reassessed at 4, 8, and 12 weeks post-discharge.

Six-Minute Walk Test ( 6MWT )

The six-minute walk test (6MWT) was used to assess differences between groups and over time. It is an important measure of patients' functional exercise capacity.

Time frame: Patients were assessed before discharge as the baseline, and reassessed at 4, 8, and 12 weeks post-discharge.

Secondary Outcomes

Daily walking activity:(1)total steps

The Xiaomi Mi Band 4 wearable device will be used to measure daily walking activity, including total steps. Data will be collected to compare differences between two groups over time. By analyzing changes in walking activity over a 12-week period, the effectiveness of the therapeutic intervention will be evaluated.