Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2022 Mar 30:3:780736.
doi: 10.3389/fresc.2022.780736. eCollection 2022.

Embedding Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease in the Home and Community Setting: A Rapid Review

Túlio Medina Dutra de Oliveira  1 , Adriano Luiz Pereira  1 , Giovani Bernardo Costa  2 , Liliane P de Souza Mendes  3   4 , Leonardo Barbosa de Almeida  2 , Marcelo Velloso  3 , Carla Malaguti  1
Affiliations
Review

Embedding Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease in the Home and Community Setting: A Rapid Review

Túlio Medina Dutra de Oliveira et al. Front Rehabil Sci. .

Abstract

This paper presents a rapid review of the literature for the components, benefits, barriers, and facilitators of pulmonary rehabilitation for chronic obstructive pulmonary disease (COPD) people in-home and community-based settings. seventy-six studies were included: 57 home-based pulmonary rehabilitation (HBPR) studies and 19 community-based pulmonary rehabilitation (CBPR) studies. The benefits of HBPR on exercise capacity and health-related quality of life were observed in one-group studies, studies comparing HBPR to usual care, and studies comparing to hospital-based pulmonary rehabilitation, although the benefits were less pronounced in the latter. HBPR reduced hospital admissions compared to usual care and was more cost-effective than hospital pulmonary rehabilitation. Most HBPRs were designed with low-density or customized equipment, are minimally supervised, and have a low intensity of training. Although the HBPR has flexibility and no travel burden, participants with severe disease, physical frailty, and complex comorbidities had barriers to complying with HBPR. The telerehabilitation program, a facilitator for HBPR, is feasible and safe. CBPR was offered in-person supervision, despite being limited to physical therapists in most studies. Benefits in exercise capacity were shown in almost all studies, but the improvement in health-related quality of life was controversial. Patients reported the benefits that facilities where they attended the CBPR including social support and the presence of an instructor. They also reported barriers, such as poor physical condition, transport difficulties, and family commitments. Despite the minimal infrastructure offered, HBPR and CBPR are feasible, safe, and provide clinical benefits to patients with COPD. Home and community settings are excellent opportunities to expand the offer of pulmonary rehabilitation programs, as long as they follow protocols that ensure quality and safety following current guidelines.

Keywords: chronic obstructive pulmonary disease; community health; home care services; pulmonary rehabilitation; telerehabilitation.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram.
See this image and copyright information in PMC

References

    1. McCarthy B, Casey D, Devane D, Murphy K, Murphy E, Lacasse Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. (2015) 23:CD003793. 10.1002/14651858.CD003793.pub3 - DOI - PMC - PubMed
    1. Puhan MA, Gimeno-Santos E, Cates CJ, Troosters T. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. (2016) 12:CD005305. 10.1002/14651858.CD005305.pub4 - DOI - PMC - PubMed
    1. Steiner MH, Holzhauer-Barrie J, Lowe D, Searle L, Skipper E, Welham S, et al. . Pulmonary rehabilitation: steps to breathe better. in National Chronic Obstructive Pulmonary Disease (COPD) Audit Programme: Clinical Audit of Pulmonary Rehabilitation Services in England and Wales 2015. London: Royal College of Physicians; (2016).
    1. Rochester CL, Vogiatzis I, Holland AE, Lareau SC, Marciniuk DD, Puhan MA, et al. . An official American thoracic society/European respiratory society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am J Respir Crit Care Med. (2015) 192:1373–86. 10.1164/rccm.201510-1966ST - DOI - PubMed
    1. Spruit MA, Pitta F, Garvey C, ZuWallack RL, Roberts CM, Collins EG, et al. . Differences in content and organisational aspects of pulmonary rehabilitation programmes. Eur Respir J. (2014) 43:1326–37. 10.1183/09031936.00145613 - DOI - PubMed

LinkOut - more resources