The cost/benefits of outpatient-based pulmonary rehabilitation

Abstract

Objective: To evaluate the outcomes of an inexpensive outpatient pulmonary rehabilitation program for stable patients with chronic obstructive pulmonary disease (COPD).

Design: Before-and-after trial.

Setting: Private, ambulatory setting with carryover to the home.

Patients: Forty-six stable COPD patients, from 45 to 80 years of age.

Interventions: A pulmonary rehabilitation program consisting of education, training, group therapy, and an individualized regimen of home-based extremity and inspiratory muscle exercise with weekly ambulatory sessions over a 10-week period.

Main outcome measures: Symptom-limited oxygen consumption (SLVO2), distance walked in 12 minutes (12 MW), dyspnea, endurance, forced expiratory volumes, minute ventilation (MV), changes in heart rate and blood pressure, and inspiratory muscle work tolerance (IMWT).

Results: There were significant increases (p < .05) in SLVO2, 12 MW, inspiratory muscle and bicycle work capacity, and forced vital capacity (FVC). The sensation of dyspnea significantly decreased during the performance of activities of daily living (ADL) (p < .05). There was no significant change in forced expiratory volume in 1 second (FEV1). The cost of the 10 outpatient sessions was $650.

Conclusions: An inexpensive outpatient/home-based pulmonary rehabilitation program provided largely by a specifically trained therapist under physician supervision can significantly improve parameters associated with quality of life for patients with COPD.