Novel Approach on Pulmonary Rehabilitation for AECOPD GOLD 1-3: A Single-blinded Randomised Controlled Trial Protocol

Abstract

Background and Objectives: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common progressive chronic lung disease characterized by irreversible airflow limitation, leading to worsening quality of life (QOL). Pulmonary rehabilitation is an essential treatment in the management of AECOPD patients. We aim to develop a novel approach to a pulmonary rehabilitation program for hospitalized AECOPD. Methods: This randomized controlled trial will include a total of 62 inpatient AECOPD and will randomly be divided into experimental (n=31) and control (n=31) groups. The experimental group will receive autogenic drainage (AD) and walking exercise, whereas the control group will receive conventional chest physiotherapy. Treatment will be conducted for four consecutive days, two sessions per day. The primary outcome will utilize the VAS pain scale, Modified Borg Dyspnea scale, lung spirometry test and six-minute walk test (6MWT). All these assessments will be measured at baseline and post intervention. The secondary outcome is quality of life and will be measured by using the St George’s Respiratory Questionnaire, Malay version (SQRQ- CM). QoL will be assessed at baseline and post four weeks hospitalization. Results: The novel approach by combining AD and walking exercise is expected to be able to improve pain, dyspnea, lung volumes, aerobic capacity and QOL in patients with GOLD 1 -3 AECOPD. This approach is easy and convenient to be carried out in ward setting as well as giving clinician an evidence-based practice guidance.