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Dyspnea is a common and troubling symptom among patients with chronic obstructive pulmonary disease (COPD). It can affect both the ability to tolerate activity and quality of life. Pulmonary rehabilitation programs have been shown to be beneficial, but they may not be available or easily accessible. Researchers at the University of California-San Francisco evaluated the impact of a self-management program on dyspnea, exercise capacity, the performance of activities of daily living, and on the quality of patients' lives.


One hundred fifteen patients were enrolled in the study originally (103 made it through the year of follow-up), and all received individualized education regarding dyspnea and self-management strategies; these entailed walking at one's maximum gait for 20 minutes at least four times a week. They also received biweekly calls from a study nurse to monitor progress and provide feedback.


Patients in a second group received four supervised treadmill exercise sessions, and patients in a third group received 24 supervised treadmill sessions coupled with behavior modification techniques used to decrease patients' fear of dyspnea.


At one year, patients in all three groups reported less dyspnea with daily activities and improvements in physical functioning and on quality-of-life assessments. The group that received treadmill and behavior modification sessions also showed improved endurance in the training laboratory.


When reached for comment, lead author Virginia Carrieri-Kohlman noted that "If 24 supervised exercise sessions are added to the basic program [which resembles most pulmonary rehabilitation programs], the decrease in dyspnea is even greater. Exercise is good, and 'more is even better' for symptom control in chronic illness."


Carrieri-Kohlman V, et al. J Cardiopulm Rehabil 2005;25(5):275-84.