Immediate in hospital reactivation of patients with an exacerbation of COPD: Pulmofit-MST

Little is known about effects of immediate reactivation in COPD-patients hospitalized for an acute exacerbation. In a semi-randomised trial, the effects of an immediate reactivation programme (PULMOFIT-MST) on length of stay in the hospital will be evaluated.




Directly after admission patients are allocated to an intervention (n=40) or control ward (n=40). All patients receive usual care. In addition, intervention patients receive PULMOFIT-MST. The protocol of the programme aims at an active role of COPD-patients during their stay in the hospital. Patients are asked to perform three daily training sessions of 15 minutes each. One daily session is assisted by a physiotherapist, while the other two have to be performed by the patients themselves.




We developed an immediate reactivation programme, entitled PULMOFIT-MST, which can hypothetically induce a reduction of the length of stay in the hospital, by preventing loss of peripheral muscle force and exercise capacity and thereby initiating a faster recovery of activities of daily living. We will evaluate the effect of the programme on length of hospital stay. Secondary outcome measures are: changes in walking distance, activities of daily living, dyspnoea, quality of life, and number of readmissions within 28 days.

Pulmofit-MST, an immediate reactivation programme, will induce a reduction of the length of stay in the hospital, by preventing loss of peripheral muscle force and exercise capacity and thereby initiating a faster recovery of activities of daily living.

All patients had to undergo measurements on day 0, day 4 and day of medical discharge.

The protocol of the programme aimed at an active role of COPD-patients during their stay in the hospital. Patients were asked to perform three daily training sessions of 15 minutes each. One daily session was assisted by a physiotherapist, while the other two had to be performed by the patients themselves. PULMOFIT-MST consists of four levels of increasing difficulty. Within four hours after admission, level I was started by the nurse who distributed the workbook with the description of all exercises and who instructed the first exercises to the patient. Within 24 hours after admission, the physiotherapist visited the patient and continued the programme by choosing the appropriate follow-up level and determining the intensity of the exercises. Every day the physiotherapist evaluated the exercises and the appropriateness of the training level and training intensity. A workbook functioned as a daily diary in which the intensities of training exercises were noted by the physiotherapist and daily experiences and improvements by the patient. All disciplines (chest physicians, nurses, and physiotherapists) stimulated patients to perform all three daily PULMOFIT-MST sessions.




Patients in the conrol group received usual care, meaning treatment the patients would have received prior to this study.