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Home-Based Pulmonary Rehabilitation in Very Severe COPD: IS IT SAFE AND USEFUL?

Fernández, Alejandro Muñoz MD; Pascual, J. MD; Ferrando, C. MD; Arnal, A. PT; Vergara, I. PT; Sevila, V. PT

Journal of Cardiopulmonary Rehabilitation and Prevention: September-October 2009 - Volume 29 - Issue 5 - p 325–331
doi: 10.1097/HCR.0b013e3181ac7b9d
PULMONARY REHABILITATION
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OBJECTIVE To determine the safety and usefulness of a home-based pulmonary rehabilitation program for patients with very severe chronic obstructive pulmonary disease (COPD) who receive long-term treatment with oxygen.

METHODS A randomized prospective study that included 50 patients with very severe COPD undergoing long-term treatment with oxygen. At the start of the program and after 12 months, the following evaluations were performed: pulmonary function tests, submaximal exercise capability, and quality of life. The rehabilitation program lasted for 1 year, with periodic home visits by a physiotherapist and included respiratory reeducation training of the respiratory muscles and muscular training.

RESULTS Forty-two patients completed the study (27 in the rehabilitation group and 15 in the control group). There were no initial differences between the 2 groups. No complications arising from the performance of the exercises were observed. The rehabilitation group showed a clinically significant increase in the distance covered in the 6-minute walk test (313 ± 72 m vs 392 ± 82 m, P = .0001) and a clinically significant reduction in the St George's Respiratory Questionnaire score (55.3 ± 15.0 vs 40.5 ± 13.8, P = .0001). No significant changes were found in any of the parameters studied in the control group.

CONCLUSION A home-based pulmonary rehabilitation program for patients with very severe COPD under long-term oxygen treatment is safe and useful, as it achieves an improvement in exercise tolerance, reduces dyspnea after effort, and improves quality of life without causing any complication arising from the performance of the exercises.

To determine the safety and usefulness of a home-based pulmonary rehabilitation program for patients with chronic obstructive pulmonary disease who were receiving long-term oxygen treatment, a randomized prospective study was conducted. The rehabilitation group showed improvements in functional capacity and quality of life. A home-based pulmonary rehabilitation program for this patients group is safe and useful.

Author Affiliations: Hospital Virgen de los Lirios, Alcoy (Drs Muñoz, Pascual, and Ferrando), VitalAire, Valencia (Mrs Arnal and Mr Vergara), and Hospital General Universitario de Alicante, Alicante (Mrs Sevila), Spain.

Corresponding Author: Alejandro Muñoz Fernández, MD, Hospital Virgen de los Lirios, Alcoy, Spain (alejandro_mf@ono.com).

© 2009 Lippincott Williams & Wilkins, Inc.