Outpatient vs. home-based pulmonary rehabilitation in COPD: a randomized controlled trial

Julio C. Mendes de Oliveira; Fernando S. Studart Leitão Filho; Luciana M. Malosa Sampaio; Ana C. Negrinho de Oliveira; Raquel Pastrello Hirata; Dirceu Costa; Claudio F. Donner; Luis V.F. de Oliveira

doi:10.4081/mrm.2010.561

Outpatient vs. home-based pulmonary rehabilitation in COPD: a randomized controlled trial

Authors

Julio C. Mendes de Oliveira Institute of the Lung, Cascavel, PR; Rehabilitation Sciences Master’s Program Department, Nove de Julho University, Sao Paulo, SP
Fernando S. Studart Leitão Filho Rehabilitation Sciences Master’s Program Department, Nove de Julho University, Sao Paulo, SP
Luciana M. Malosa Sampaio Rehabilitation Sciences Master’s Program Department, Nove de Julho University, Sao Paulo, SP
Ana C. Negrinho de Oliveira Institute of the Lung, Cascavel, PR,
Raquel Pastrello Hirata Rehabilitation Sciences Master’s Program Department, Nove de Julho University, Sao Paulo, SP
Dirceu Costa Rehabilitation Sciences Master’s Program Department, Nove de Julho University, Sao Paulo, SP
Claudio F. Donner Mondo Medico, Multidisciplinary and Rehabilitation Outpatient Clinic, Borgomanero (NO)
Luis V.F. de Oliveira Rehabilitation Sciences Master’s Program Department, Nove de Julho University, Sao Paulo, SP

DOI: https://doi.org/10.4081/mrm.2010.561

Keywords:

COPD, home-based pulmonary rehabilitation, pul- monary rehabilitation.

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a common cause of morbidity and mortality affecting a large number of individuals in both developed and developing countries and it represents a significant financial burden for patients, families and society. Pulmonary rehabilitation (PR) is a multidisciplinary program that integrates components of exercise training, education, nutritional support, psychologi- cal support and self-care, resulting in an improvement in dyspnea, fatigue and quality of life. Despite its proven effectiveness and the strong scientific recommendations for its rou- tine use in the care of COPD, PR is generally underutilized and strategies for increasing access to PR are needed. Home- based self-monitored pulmonary rehabilitation is an alternative to outpatient rehabilitation. In the present study, patients with mild, moderate and severe COPD submitted to either an outpatient or at-home PR program for 12 weeks were analyzed.

Methods: Patients who fulfilled the inclusion criteria were randomized into three distinct groups: an outpatient group who performed all activities at the clinic, a home-based group who performed the activities at home and a control group. PR consisted of a combination of aerobic exercises and strength- ening of upper and lower limbs 3 times a week for 12 weeks.

Results: There was a significant difference in the distance cov- ered on the six-minute walk test (p < 0.05) and BODE index (p < 0.001) in the outpatient and at-home groups after partici- pating in the rehabilitation program compared to baseline.

Conclusion: A home-based self-monitoring pulmonary reha- bilitation program is as effective as outpatient pulmonary rehabilitation and is a valid alternative for the management of patients with COPD.