Elsevier

Respiratory Medicine

Volume 99, Issue 10, October 2005, Pages 1297-1302
Respiratory Medicine

Extending a home from hospital care programme for COPD exacerbations to include pulmonary rehabilitation

https://doi.org/10.1016/j.rmed.2005.02.033Get rights and content
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Summary

The principals of rehabilitation medicine are to prevent muscle atrophy and improve mobility. Exacerbations of chronic obstructive pulmonary disease (COPD) are associated with muscle atrophy and yet many patients do not undergo pulmonary rehabilitation until they have been in stable health for some time. We investigated the outcome of a supervised home exercise programme initiated immediately after hospitalisation for an exacerbation of COPD. Thirty-one patients were randomised into an exercise group (n=16, FEV1 0.94±0.34 L) and a control group (n=15, FEV1 1.08±0.33 L). The exercise group received a twice-weekly supervised exercise programme, in their homes, for 6 weeks. Spirometry, exercise capacity, isometric muscle strength, dyspnea level, quality of life at baseline and 6 weeks as well as subsequent exacerbations were quantified. At 6 weeks, the exercise group, improved the shuttle walk test (198 m±95–304±136 m) and increased 3 min step test capacity (119±40–163±26 s) (both P<0.001). Knee extensor muscle strength and quality of life scores also increased. Neither exercise capacity nor muscle strength altered in the control group. Follow-up at 3 months showed that three of the control group and none of the exercise group had experienced subsequent exacerbations (P=0.06). Early rehabilitation via a home from hospital programme improved exercise tolerance, muscle strength, dyspnea scores, quality of life in COPD patients and reduced the number of subsequent exacerbations.

Keywords

Community rehabilitation
Emphysema
Exacerbation of COPD
Home from hospital

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