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. 2010 Dec 20;5(6):401-8.
doi: 10.1186/2049-6958-5-6-401.

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

Júlio C Mendes de Oliveira  1 , Fernando S Studart Leitão Filho, Luciana M Malosa Sampaio, Ana C Negrinho de Oliveira, Raquel Pastrello Hirata, Dirceu Costa, Claudio F Donner, Luís Vf de Oliveira
Affiliations

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

Júlio C Mendes de Oliveira et al. Multidiscip Respir Med. .

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, psychological 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 routine 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 strengthening of upper and lower limbs 3 times a week for 12 weeks.

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

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

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Figures

Figure 1
Figure 1
Flowchart of study design.
Figure 2
Figure 2
Intra-group results of distance walked on six-minute walk test before and after rehabilitation program.
Figure 3
Figure 3
Variation on six-minute walk test between groups before and after rehabilitation program.
Figure 4
Figure 4
Bode index variation before and after rehabilitation program.
See this image and copyright information in PMC

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