Enhanced External Counterpulsation Efficacy on Exercise Endurance in COPD Patients and Healthy Subjects: A Pilot Randomized Clinical Trial

PURPOSE: Enhanced external counterpulsation (EECP) is popular in China for the treatment of coronary heart diseases, but it may be an effective treatment for other populations. This study aimed to explore the effect of EECP on exercise endurance of healthy people and chronic obstructive pulmonary disease (COPD) patients and provide intervention measures to improve their physical condition. PATIENTS AND METHODS: Patients were enrolled in this pilot randomized controlled trial at Jiangbin Hospital, China, between March 1st and May 30th, 2018. They were randomly divided into the EECP and non-EECP groups. According to their maximal oxygen uptake, the volunteers were also sub-grouped into the normal, low exercise endurance, and COPD subgroups. Differences in exercise endurance were evaluated between the EECP and non-EECP groups before and after treatment. Cardiopulmonary exercise testng included anaerobic threshold oxygen uptake (AT-VO(2)Kg), maximum oxygen uptake (Max-VO(2)Kg), anaerobic threshold pulse (AT-O(2)puls), anaerobic threshold metabolic equivalent (AT-Mets), and maximum metabolic equivalent (Max-Mets). RESULTS: 72 volunteers were enrolled. The EECP and non-EECP groups were similar in terms of age, sex, body mass index, blood pressure, heart rate, breathing frequency, AT-VO(2)Kg, Max-VO(2)Kg, AT-O(2)puls, AT-Mets, and Max-Mets (P > 0.05) before treatment. EECP significantly improved AT-VO(2)Kg, Max-VO(2)Kg, AT-O(2)puls, AT-Mets, and Max-Mets compared with the non-EECP group (P<0.05). When analyzed according to sub-groups, the AT-VO(2)Kg, Max-VO(2)Kg, AT-O(2)puls, AT-Mets, and Max-Mets of the normal, low exercise endurance, and COPD subgroups were all significantly increased after EECP (P<0.05). CONCLUSION: EECP significantly improved the exercise endurance of normal adults, low endurance adults, and COPD patients. REGISTRATION NUMBER: ChiCTR1900021993.