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A Feasibility Trial of Two Rehabilitation Models in Severe Cardiopulmonary Illness

Steele, Bonnie G., ARNP, PhD1; Dougherty, Cynthia M., ARNP, PhD, FAAN1,2; Burr, Robert L., MSEE, PhD2; Colwell, Ina Gylys, MS1; Hunziker, James, MSN, ARNP1

doi: 10.1097/rnj.0000000000000115

Purpose The purpose of this study was to compare functional capacity and daily activity between two exercise rehabilitation interventions in severe chronic obstructive pulmonary disease (COPD) or heart failure with reduced ejection fraction (HFrEF) over 6 months. Secondarily, we compared intervention groups on symptoms, depression, quality of life, and cardiopulmonary function.

Design/Methods Ninety patients with severe COPD (n = 63) or HFrEF (n = 27) were randomized to either an exercise adherence intervention or standard cardiopulmonary rehabilitation. Patients were 65-year-old male veterans who had either severe COPD (FEV1 < 50% predicted) or HFrEF (EF% < 40%).

Results There were no statistically significant differences between the intervention groups or COPD or HfrEF groups on functional capacity, daily activity, symptoms, depression, quality of life, or cardiopulmonary function at 6 months.

Conclusion In late-stage COPD and HFrEF, functional capacity is not improved with rehabilitation interventions.

Clinical Relevance In severe COPD and heart failure, cardiopulmonary rehabilitation conducted at home or in the outpatient setting was not beneficial.

1 VA Puget Sound Health Care System, Seattle, WA, USA

2 University of Washington School of Nursing, Seattle, WA, USA

Correspondence: Cynthia M. Dougherty, University of Washington School of Nursing, 1959 NE Pacific Street, HSB T615A, Box 357266, Seattle, WA 98195. E-mail:

The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.

Funding: VA HSR&D, NRI 04–242. The authors declare no conflicts of interest.

Clinical Trials Registration Number: NCT00467298.

Cite this article as: Steele, B. G., Dougherty, C. M., Burr, R. L., Gylys-Colwell, I., & Hunziker, J. (2019). A Feasibility trial of two rehabilitation models in severe cardiopulmonary illness. Rehabilitation Nursing, 44(3), 130–140. doi: 10.1097/rnj.0000000000000115

© 2019 Association of Rehabilitation Nurses.
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