The Role of Pedometer Based Walking Exercise To Quadriceps Muscle, Quality of Life, Benefit, and Cost in Stable COPD Patient

Jatu Aviani, Suradi Suradi, Ana Rima


Background: Quadriceps muscle dysfunction in COPD is caused by systemic or local inflammation, hypoxia, hypercapnia, corticosteroid use, nutritional depletion, anabolic / catabolic hormone imbalances, oxidative stress, genetic susceptibility, and decreased daily activity. Decreased quadriceps muscle strength reduces exercise capacity, physical activity, increased shortness of breath, and decreased quality of life. Walking increases the quadriceps muscle strenght and overcomes deconditioning. The purpose of this study was to analyze effect of pedometer-based exercise on quadriceps muscle strength, quality of life, benefits, and cost of patients with stable chronic obstructive pulmonary disease.
Methods: A clinical study with experimental quasi pre-post test control group design using consecutive sampling was performed in patient’s with stable COPD in Dr.Moewardi Hospital from September to November 2018. Subjects were divided into intervention group which were given pedometer based walking exercise for six weeks and control group with standard rehabilitation. Quadriceps muscle strength, SGRQ score, LCADL score, and cost effectiveness were measured before and after exercise.
Results: Twenty seven patients of stable COPD were included in this study. The intervention groups showed increased quadriceps muscle strength (2,58+0,49), decreased SGRQ scores (23,39+6,60), decreased LCDAL scores (-5,69+2,18), and cost effectiveness compared to control group (p<0,005).
Conclusion: Pedometer based walking exercise within six weeks increased quadriceps muscle strength, quality of life, benefit, and cost effectiveness in stable COPD patients.


stable COPD, quadriceps muscle strenght, SGRQ, LCDAL, cost


Global initiative for chronic obstructive lung disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. Capetown: Global initiative for chronic obstructive lung disease Inc; 2016. p. 2-7.

Troosters T, Molen T, Polkey M, Rabinovich R, Vogiatzis I, Weisman I, etal. Improving physical activity in COPD: towards a new paradigm. Respir Research. 2013;14:1-8.

Bolton CE, Smith EF, Blakey JD, Crowe P, Elkin SL, Garrod R. British thoracic society guideline on pulmonary rehabilitation in adults. Thorax. 2013;68:1-30.

Carlin BW. Pulmonary rehabilitation and chronic lung disease: oppurtinities for respiratory therapist. Respir Care. 2009;54:1091-8.

Alison JA, McKeough ZJ. Pulmonary rehabilitation for COPD: are programs with minimal exercise equipment effective?. J Thoracic Dis. 2014;6:1606-14.

Choi B, Pak A, Choi J, Choi E. Daily step goal of 10.000 steps: a literature review. Clin

Invest Med. 2007;30:146-51.

Mendoza L, Horta P, Espinoza J, Aguilera M, Balmacela N, Castro A, e tal. Pedometers to enhance physical activity in COPD: a randomized controlled trial. Eur Respir J. 2014;10:1-8.

Wright JL, Chung A. Pathology of chronic obstructive pulmonary disease:diagnostic features and differential diagnosis. In: Grippi MA, Ellias JA, Fishman JA, Kotloff RM,

Pack AI, Senior RM, editors. Fisman pulmonary disease and disorder. 5th ed. New York: McGraw Hill; 2015. p. 600-44.

Stockley RA, Mannino D, Barnes PJ. Burden and pathogenesis of chronic obstructive pulmonary disease. Proceeding of ATS. 2009;6:524-6.

Dahlan M. Uji hipotesis komparatif variable numerik dan kelompok. In: Dahlan M, editor. Statistik unutk kedokteran dan kesehatan: deskriptif, bivariat, dan multivariate. 4 ed. Jakarta: Salemba Medika; 2009. p. 59-83.

Bertici N, Mladinescu O, Oancea C, Tudorache V. The usefulness of pedometry in patients with chronic obstructive pulmonary disease. Multidiciplinary Respiratory Medicine. 2013;8:1-4.

Aphridasari J. Pengaruh exercise training dan neuromuscular electrostimulation (NMES) terhadap derajat obstruksi dan kekuatan otot quadriceps penderita penyakit paru obstruktif kronik. [Thesis]. Departement of Pulmonology and Respiratory Medicine Medical Faculty: Sebelas Maret University; 2007.

Holland AE. Time to adapt exercise training regimens in pulmonary rehabilitation a review of the literature. Int J COPD.2014;9:1275-88.

Nyberg A, Carvalho J, Bui KL, Saey D, Maltais F. Adaptations in limb muscle function following pulmonary rehabilitation in patients with COPD – a review. Revista Portuguesa de Pneumologia. 2016;22(6): 342-50.

American Association of Cardiovascular and Pulmonary Rehabilitation. Guidelines for pulmonary rehabilitation programs. United States of America; 2011. p. 1-195.

Jones PW, Brusselle G, Negro RWD, Ferrer M, Kardos P, Levy ML, et al. Healthrelated quality of life in patients by copd severity within primary care in Europe. Respur Res. 2010;3:57-67.

Rous MR. Betoret RD, Aldas JS. Pulmonary rehabilitation and respiratory physiotherapy: time to push ahead. Arch Broncopneumol. 2008;44(1):35-40.

Nascimento ESP, Sampaio LCM, Souza FSP, Dias FD, Gomes ELFD, Greiffo FR, et al. Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients. Int J COPD. 2015;10:645-53.

Farias CC, Resqueti V, Fernando A, Dias L, Borghi-Silva A, Arena R, et al. Costs and benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease: a randomized controlled trial. Braz J Phys Ther. 2014; 18(2):165-73.

Gea J, Pascual S, Casadevall C, Levi MO, Barreioro E. Muscle dysfunction in chronic obstructive pulmonary disease: update on causes and biological findings. J Thorax Dis. 2015;7(10):418-38.

Nascimento E, Sampaio LMM, Souza F, Dias FD, Gomes E, Greiffo FG, et al. Home based rehabilitation improves clinical feature and systemic inflammation in chronic obstructive pulmonary disease patients. Int J COPD. 2015;10:645-53.

Widyastuti K, Makhabah DN, Setijadi AR, Sutanto YS, Suradi, Ambrosino N. Benefits and costs of home pedometer assisted physical activity in patients with COPD. A preliminary randomized controlled trial. Pulmonol. 2018;16:1-8.



  • There are currently no refbacks.

Jurnal Respirologi Indonesia
pISSN: 0853-7704 - eISSN: 2620-3162
Address: Jalan Cipinang Bunder No. 19, Cipinang, Pulogadung, Jakarta Timur, DKI Jakarta 13240, Indonesia
Phone: +62-21-2247-4845

An official publication by
the Indonesian Society of Respirology (ISR)

Creative Commons License
Creative Commons Attribution-NonCommercial 4.0 International License