Chest
Clinical Investigations: RehabilitationResults of a Home-Based Training Program for Patients With COPD
Section snippets
Patients
We studied 60 patients who had COPD diagnosed in accordance with the European Respiratory Society Consensus Statement,1 which defines this illness as a disorder characterized by decreased maximum expiratory flow and slow forced emptying of the lungs that is slowly progressive, irreversible, and does not change markedly over several months. All patients were in a stable phase of their disease with optimal drug management (ie, bronchodilator therapy and oxygen therapy, if necessary). The criteria
Results
Ten patients dropped out of the rehabilitation group: 6 left for lack of cooperation (20%), and 4 were excluded due to acute exacerbation of their underlying pathology. Thirteen patients dropped out the control group: 7 did not cooperate with evaluations (23%); 4 had acute exacerbations; 1 had suffered a cerebral vascular accident; and 1 was waiting for prostate cancer surgery. Twenty patients from the rehabilitation group and 17 from the control group completed the study.
Baseline pulmonary
Discussion
With our simple home-based program of standardized training for the muscles of ambulation, our group of COPD patients with moderate disease showed improvement in their tolerance of submaximal exercise, in dyspnea, and in quality of life. These results are similar to those found in the literature,7,8 although the latter were obtained through rather complex rehabilitation programs.
We did not find changes in pulmonary function or in arterial blood gas levels.13, 14, 15, 16 We also did not find
ACKNOWLEDGMENT
The authors thank Dr. Cayuela for his assistance in the statistical analyses, and Drs. Cejudo and Whaley for their assistance in the translation of the manuscript into English.
References (42)
Disease management of COPD with pulmonary rehabilitation.
Chest
(1997)- et al.
Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease.
Lancet
(1996) - et al.
Economic analysis of respiratory rehabilitation.
Chest
(1997) - et al.
A comparison between an outpatient hospital-based pulmonary rehabilitation program in patients with COPD: a follow-up of 18 months.
Chest
(1996) - et al.
Eficacia de un programa de deshabituación al tabaco con tratamiento sustitutivo combinado de nicotina (parches mas chicles) a los 6 meses de seguimiento.
Arch Bronconeumol
(1998) - et al.
The measurement of dyspnea: contents, interobserver agreement and physiologic correlates of two new clinical indexes.
Chest
(1984) - et al.
Dyspnea in the patient with chronic obstructive pulmonary disease: etiology and management.
Clin Chest Med
(1990) - et al.
Traducción española y validación de un cuestionario de calidad de vida en pacientes con enfermedad pulmonar obstructiva crónica.
Arch Bronconeumol
(1995) - et al.
Measurement of health status: ascertaining the minimal clinically important difference.
Control Clin Trial
(1989) Exercise in chronic obstructive pulmonary disease.
Clin Chest Med
(1986)
Optimal assessment and management of chronic pulmonary obstructive disease (COPD): the European Respiratory Society Task Force.
Eur Respir J
Pulmonary rehabilitation research
NIH workshop summary Am J Respir Crit Care Med
Position paper of the American Association of Cardiovascular and Pulmonary Rehabilitation.
J Cardiopulm Rehabil
Principles and practice of pulmonary rehabilitation.
Physical rehabilitation for the chronic bronchitis: results of a controlled trial of exercises in home.
Thorax
Quality of life in patients with chronic obstructive pulmonary disease improves after rehabilitation at home.
Eur Respir J
Long term benefits of rehabilitation at home on quality of life and exercise tolerance in patients with chronic obstructive pulmonary disease.
Thorax
Long-term effects of home rehabilitation on physical performance in chronic obstructive pulmonary disease.
Am J Respir Crit Care Med
The effects of a community-based pulmonary rehabilitation program on exercise tolerance and quality of life: a randomized controlled trial.
Eur Respir J
Cited by (153)
Effect of pulmonary rehabilitation programs including lower limb endurance training on dyspnea in stable COPD: A systematic review and meta-analysis
2020, Respiratory InvestigationCitation Excerpt :For each of the SGRQ domains, the common effect size exceeded the MCID of 4. The CRQ total score was evaluated in 10 studies and 820 participants [19,29,32,43,44,47–49,55], and the mean change was significantly greater in the intervention group than in the control group (MD, 5.13; 95% CI, 2.30 to 7.96; p = 0.0004; I2 = 93%) (Fig. 5B). The mean change in the CRQ fatigue domain was not different between groups (14 studies and 921 participants, MD, 0.53; 95% CI, −0.09 to 1.15; p = 0.09; I2 = 49%) (Supplementary Fig. S7).
Does home-based pulmonary rehabilitation improve functional capacity, peripheral muscle strength and quality of life in patients with bronchiectasis compared to standard care?
2017, Brazilian Journal of Physical TherapyCitation Excerpt :COPD is the most investigated lung disease both in terms of outpatient PR and HBPR. In patients with COPD, HBPR was first described in the mid-90s9 and since then, numerous studies have shown that, similar to outpatient rehabilitation, home-based programs improve quality of life, increase exercise tolerance, and improve dyspnea without serious side effects.10–22 Since 2010, the effects of HBPR have been extended to other chronic lung diseases, such as idiopathic pulmonary fibrosis,23,24 asthma,7,25 and tuberculosis,26with similar results to those described in patients with COPD.