Strengthening Exercises for Functional

Improvement in Respiratory Disorder -

Randomized Control Trial
Ramesh Babu Manivannan
Deputy Dean / Head of Physiotherapy Department
Lincoln University College

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This study is conducted at GetWell Physiotherapy Centre, part of Lincoln
University College and documentation based care Physiotherapy Centre,
Ipoh.

This study is conducted by Ramesh Babu Maivannan, Saravanan

Govindasamy, Kohila Letchumanan, Hemashangkari Boopalan and Anees
Sabiya.

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Background:
Even though exercises included in Conventional Pulmonary rehabilitation,
effects of strengthening exercises on endurance and functional
improvement is not clearly outlined.

Objective:
This study has been conducted to analyze the effects of strengthening
exercises added with conventional pulmonary rehabilitation for patients
with respiratory disorders.

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Materials and Methods:
• Thirty patients with respiratory disorders ranging from mild to moderate level
were selected by randomization.
• Control group has been applied with Conventional Pulmonary Rehabilitation
(CPR) techniques of Breathing exercises, thoracic expansion exercises and
spirometric exercises.
• The interventional group is applied with strengthening exercise of Upper Limb
and Lower Limb with Conventional Pulmonary Rehabilitation (SCPR).
• The CPR protocol is applied for 30-45 minutes per session for 12 weeks.
• SCPR protocol is applied for 45-60 minutes of sessions with weight loaded
equipment with weights vary from 5 kg to 25 kg with 60 repetitions for 12 weeks.
• MRC breathless scale and 6 Minute walk test have been used as Measuring tools
pre and post-exercise sessions.
• All the 30 patients completed the activity for 12 weeks as a study group.
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 PATIENT CHARACTEIRSTICS

(n=30)
Mean Age 30+8
Gender (Male / Female) 18/12
Mean Height 1.6+0.1 M
Mean Weight 68+8 Kg

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Application of 6 MWT and MRC Breathless Application of 6 MWT and MRC Breathless
scale (Pre-test) scale (Pre-test)

Application of conventional chest Application of conventional chest

physiotherapy (Breathing exercises, physiotherapy with strengthening exercises
Spirometry exercises, Thoracic expansion using weight loaded equipments
exercises)

Application of 6 MWT and MRC Breathless scale Application of 6 MWT and MRC Breathless scale
(Post-test) (Post-test)

Result Result

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Results:
• 6 Minute walk test have shown significant improvement in both groups
(p < 0.05), but SCPR group has shown better improvement p (30 ± 10%
versus 12 ± 10% [mean ± SD] in the CPR group, p < 0.005).

• Strengthening of upper and lower limb muscles has been noted as a

factor increases the endurance in MRC breathless scale as 20 ± 10% (p <
0.001) in SCPR, but CPR group has shown very lower level of
improvement in endurance (5 ± 8% p > 0.05).

• The difference between SCPR and CPR in terms of functional

improvement has been noted significantly (p < 0.01).
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 CONTROL GROUP
PRE-TEST POST-TEST RESULT
6MWT 10+3 12+10 12+10
MRC BREATHLESS SCALE 5+1 4+1 1+1
6MWT

PRE-TEST
4
PRE-TEST POST-TEST
10 POST-TEST

5
12

6 MINUTE WALK TEST RESULTS MRC BREATHLESS SCALE RESULTS

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INTERVENTIONAL GROUP
PRE-TEST POST-TEST RESULT
6MWT 12+3 30+10% 18+8
MRC BREATHLESS SCALE 5+1 1+1 4+1

1
12
PRE-TEST
PRE-TEST

POST-TEST POST-TEST

30
5

6 MINUTE WALK TEST RESULTS MRC BREATHLESS SCALE RESULTS

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 COMPARISON BETWEEN INTERVENTIONAL AND CONTROL GROUP
6MWT MRC BREATHLESS SCALE

4
18

16 3.5

14 3

12 2.5

10
2

8
1.5
6
1
4
0.5
2

0
0
CONTROL GROUP INTERVENTIONAL GROUP
CONTROL GROUP INTERVENTIONAL GROUP

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Conclusion:
Increase in endurance by strengthening exercises has shown a
better result compared to Conventional Pulmonary Rehabilitation in
MRC breathless scale and 6 Minute walk test. Thus the study has
concluded that adding strengthening exercises with weight loaded
equipment increases the endurance thereby breathless is reduced
significantly in patients with respiratory disorders.

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THANK YOU

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