Evaluation of a prospective randomized controlled exercise program for people recovering from severe acute respiratory syndrome (SARS)

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Evaluation of a prospective randomized controlled exercise program for people recovering from severe acute respiratory syndrome (SARS)


Author: Lau, Mun-cheung Herman
Title: Evaluation of a prospective randomized controlled exercise program for people recovering from severe acute respiratory syndrome (SARS)
Degree: M.Phil.
Year: 2006
Subject: Hong Kong Polytechnic University -- Dissertations.
SARS (Disease) -- Patients -- Rehabilition -- China -- Hong Kong.
Exercise therapy.
Department: Dept. of Rehabilitation Sciences
Pages: xiv, 108 leaves : ill. ; 31 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2093862
URI: http://theses.lib.polyu.edu.hk/handle/200/2257
Abstract: This thesis reported the outcome of a prospective epidemiological cohort study by comparing the physical fitness and the health-related quality of life (HRQoL) status between the subjects with normal health and the patients who survived from Severe Acute Respiratory Syndrome (SARS). The second phase of the study included a randomized clinical controlled trial which aimed to evaluate the effect of a 6-week supervised training program at both short-term (immediately after completion of the exercise program) and at 6-month post-training on their physical and HRQoL status. A total of 171 post-SARS patients discharged from the Prince of Wales Hospital (PWH) in Hong Kong were recruited for the first part of the study. The mean age of these patients was 37.36+-12.65 years and their averaged length of hospitalization was 21.79+-9.93 days. 133 of them were then recruited into a randomized controlled trial. They were randomized into two groups, namely, the supervised exercise group and the home-based control group. Patients in the home-based control group received a standardized educational session from the physiotherapists on general exercise advice and an exercise VCD for performing the exercises at home while patients in the supervised exercise group were arranged to join a 6-week training program conducted in the physiotherapy department of PWH in addition to the general advice and the exercise VCD. Follow up assessment was arranged for both groups of patients six months after the 6-week training. A total of 98 subjects completed all the evaluation procedures. The physical outcomes of the patients were measured by a series of tests which included a 6-minute walk test, a Chester step test (for predicted maximal oxygen consumption), testing of the handgrip strength and proximal muscles strength of both the upper and lower limbs, 1-minute curl-up and push-up tests, and a SF-36 questionnaire for measuring the HRQoL status. The test results revealed that the 6-minute walk distance, the predicted VO2max, the large and small muscle strength, and the scores in SF-36 for the post-SARS patients were significantly lower than the normative value (p<0.05). After the 6-week training program, the supervised exercise group significantly demonstrated greater improvement than the home-based control group in the 6-minute walk test. Their results were 77.44m (13.11%) vs 20.71m (3.37%), p<0.001. For the predicted VO2max, the figures were 3.57ml/kg/min (10.16%) vs 0.97ml/kg/min (2.57%), p=0.036. For the musculoskeletal performance, the supervised group also had more significant improvement than the control group. Left handgrip: 4.15kgf (16.14%) vs 2.19kgf (8.59%), p<0.05, right handgrip: 4.69kgf (16.99%) vs 1.71 kgf (6.09%), p<0.05. Curl-up test: 7.06 counts (52.8%) vs 3.56 counts (25.34%), p<0.05 and push-up test: 8.59 counts (90.61%) vs 3.61 counts (37.10%), p<0.05. The HRQoL status of the two groups, however, did not reveal any significant difference. Differences in the result between the two groups were also noted at the 6-month follow-up assessment, the supervised exercise group improved more significantly than the control group in the 6-minute walk test. The figures were: 59.62m (10.09%) vs 18.64m (3.03%), p=0.022. For the predicted VO2max, the differences were 6.92ml/kg/min (16.70%) vs 3.41ml/kg/min (9.02%), p=0.049. Curl-up test: 6.23 counts (46.60%) vs 3.02 counts (21.49%), p<0.037 and push-up tests: 6.98 counts (73.63%) vs 3.37 counts (34.64%). The handgrip improvement was not significant. Left handgrip: 1.07kgf (4.16%) vs 2.39kgf (8.51%) and right handgrip: 1.76kgf (6.37%) vs 1.57kgf (5.59%). For SF-36, none of the domains showed any prominent difference between the two groups at 6 months post-training. In conclusion, SARS survivors demonstrated deficits in the cardiopulmonary and musculoskeletal performances as well as the HRQoL status after hospital discharge. The 6-week intensive exercise training program supervised by the physiotherapists was shown to be effective in improving both their cardio-respiratory and musculoskeletal performances. Nevertheless, physical training during the intervention period had no impact on HRQoL. At the 6-month post-training follow-up, similar results were obtained which proved that the training program could provide long-term physical benefits to the post-SARS patients.

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