Efficacy of One-Legged Vs Two Leg Exercise Training in Enhancingaerobic Capacity of Patients of COPD

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) is the most common disorder affecting 10-15% of adult over the age of 40. COPD is a disorder characterized by the presence of air flow obstruction that is generally progressive may be accompanied by airway hyper reactivity and may partially reversible. COPD patients shows marked decrease in the lung volumes and lung capacities leads to decrease arterial oxygen saturaisation level and over all it affects the aerobic and exercise tolerance capacity of the persons. In initial stage it produces hypoxemia and in later stage hypercapnia will occur. The cornerstone of pulmonary rehabilitation is exercise training based on the premise that altering physiologic process will result in improved outcomes. Intensity and duration are important determinants of the physiologic adaptation that occur in response to exercise. COPD patients are so limited by dyspnea, even at modest level of ventilation that their training is restricted to low intensity exercise. As a result, when undergoing exercise training they are usually unable to increase their peak oxygen uptake (vo2)) although this measures is the recognized standard for confirming the physiologic effects of aerobic exercise training. COPD patients undergoing conventional two-legged training are unable to increase their peak (vo2) because of ventilator limitation. One legged cycle training required no specific learning and patients found it at least as comfortable as two-legged training because leg fatigue is better tolerated than dyspnea. One legged cycle training placed the same metabolic and functional demands on the targeted muscle, at a lower total metabolic load and hence a lower ventilator load. AIM OF THE STUDY: The aim of study is to find out the effectiveness of one – lag exercise training in improving aerobic capacity for patients with COPD against two – lag exercise training. OBJETIVES OF THE STUDY: 1. To find the effectiveness of one – legged exercise training in improving aerobic capacity for patients with COPD. 2. To find the effectiveness of two – legged exercise training in improving aerobic capacity for patients with COPD. 3. To compare the effects of both on improving aerobic capacity for patients with COPD. DESIGN AND METHODOLOGY: Research Design: Matched subject experimental design Study Setup: MIOT Hospitals, Chennai, Global Hospital and Health City, Chennai. SAMPLING CRITERIA: Inclusion Criteria: 1. Clinically stable COPD patients. 2. Male subjects. 3. Age group 40-65. 4. Subject with smoking abstinence. Exclusion Criteria: 1. Subjects with other pulmonary disorders. 2. Subjects with osteoporosis and tuberculosis. 3. Subjects with hypoxemia at rest. 4. Subjects with neurological conditions. Population: All COPD patients, who fulfill the inclusion criteria, were included in this study. Sample Size: Total sample size is 30.They were selected from the population by using convenient sampling procedure. Group - I : Single leg exercise training (experimental group). Group - II : Double legged exercise training(controlled group). VARIABLES: Depandant Variables: VO2 Max, SpO2. Independent Variables: 1. Single legged exercise training, 2. Double legged exercise training. Material Used: 1. Bicycle ergo meter, 2. Pulse oximeter. METHODOLOGY: Group-I was receiving Single leg exercise training & GROUP-II was receiving double leg exercise training. Before giving the independent variables for each group an assessment was taken and pre test scores of VO2 Max and Sao2 were recorded. GROUP - I: Before starting the exercise program clear explanation about the training was explained to the subjects. Single leg exercise training was given in Electro mechanically bracked cycle. The inactive foot was rested on a cross bar located midway on the ergo meter head tube. The first half of the training was given in right leg and the other half of training was given on the left leg. (15 minutes on each leg) The intensity was set as 50% of the peak power and reduced as necessary to achieve 30 minutes of cycling. In the first week of the program subjects were trained at40% peak power. Once the subject reached 30 min for consecutive session, then the training workload was increased about 5%. This training program was given three times per week for six months. After the administration of Single leg exercise training the post test scores of VO2 Max and SaO2 were recorded. The other parameters mainly heart rate, blood pressure, and dyspnea are also recorded during the test. GROUP - II Before starting the exercise program clear explanation about the training was explained to the subjects. Subjects were instructed to do cycling continuously for 30 minutes. The training was given in in Electro mechanically bracked cycle. The training intensity was 70%of the peak power. In the first week of the program subjects were trained at56%peak power. Once the subject reached 30 min for consecutive session, then the training workload was increased about 5%. This training program was given three times per week for six months. After the administration of Single leg exercise training the post test scores of VO2 Max and Sao2 were recorded. The other parameters mainly heart rate, blood pressure, and dyspnea are also recorded during the test. RESULTS: The study was done on 30 subjects, which consisted of 15 subjects each for 15 days duration. The results show that: 1. Mean value of independent variable between pre and post score of Group-I shows significant difference in improvement. 2. Mean value of different variable between pre and post score of Group-II shows less significant difference in improvement. 3. Paired ’t’ tests value of pre and post score shows significant difference in experimental group. 4. Paired ’t’ tests value of pre and post score shows less significant difference in control group. 5. In Paired ’t’ tests of experimental group shows highly significant difference in improving Aerobic capacity on COPD patients. 6. The mean difference of experimental group shows significant difference in improving Aerobic capacity on COPD patients. 7. The mean difference of control group shows less significant difference in improving Aerobic capacity while comparing to experimental group. CONCLUSION: From the result of the study it was concluded that single leg exercise training is effective in improving aerobic capacity in Chronic Obstructive Pulmonary Disease patients.