Culturally Adapted Floor-to-Stand Exercises for COPD: A Quasi-Experimental Study

Conventional pulmonary rehabilitation remains difficult to access in many low-resource settings because of practical, geographic, and sociocultural barriers. Accordingly, floor-to-stand exercises (FSE) were developed as an equipment-free program centered on repeated floor-to-stand transitions that are commonly performed in daily life in North Africa. The main objective of the present study was to estimate program completion rates, identify predictors of non-completion, and describe clinical, functional, and peripheral muscle outcomes in chronic obstructive pulmonary disease (COPD) outpatients with documented difficulty rising from the floor.

In this prospective, quasi-experimental pilot study, COPD outpatients participated in the 9-week progressive FSE program. Completion was defined as ≥22 floor-to-stand transitions/day during weeks 7-9. Assessments were performed at baseline and at day 63, and outcomes were compared between completers and non-completers.

Fifteen COPD outpatients were included; the completion rate was 46.7% (7/15). Completers had lower baseline Borg CR10 scores (6.0 vs. 7.5; P = 0.047) and higher 6-minute walk distance (330 vs. 261 m; P = 0.037). On day 63, completers improved on the modified Medical Research Council Dyspnea Scale (-2.0; P = 0.015), Borg CR10 (-3.0; P = 0.011), and COPD assessment test (-8.0; P = 0.008), whereas non-completers improved only on the Borg CR10 (-2.0; P = 0.020). Functional tests and peripheral muscle outcomes showed no consistent changes overall.

The FSE was feasible and safe in this study, with improvements primarily in symptoms and disease impact. Larger controlled studies are needed to confirm the effectiveness and optimize adherence. Trial registration: ClinicalTrials.gov NCT07277855.