Background and objective: The aim of the Pulmonary Rehabilitation Guidelines (Guidelines) is to provide evidence-based recommendations for the practice of pulmonary rehabilitation (PR) specific to Australian and New Zealand healthcare contexts.

This study was designed to determine the effect of ground-based walking training on healthrelated quality of life and exercise capacity in people with chronic obstructive pulmonary disease (COPD).People with COPD were randomised to either a walking group that received supervised, ground-based walking training two to three times a week for 8-10 weeks, or a control group that received usual medical care and did not participate in exercise training.130 out of 143 participants (mean¡SD age 69¡8 years, forced expiratory volume in 1 s 43¡15% predicted) completed the study. Compared to the control group, the walking group demonstrated greater improvements in the St George's Respiratory Questionnaire total score (mean difference -6 points (95% CI -10--2), p,0.003), Chronic Respiratory Disease Questionnaire total score (mean difference 7 points (95% CI 2-11), p,0.01) and endurance shuttle walk test time (mean difference 208 s (95% CI 104-313), p,0.001).This study shows that ground-based walking training is an effective training modality that improves quality of life and endurance exercise capacity in people with COPD. @ERSpublications Walking training improves quality of life and endurance exercise capacity compared to usual medical care in COPD

We described physical activity measures and hourly patterns in patients with chronic obstructive pulmonary disease (COPD) after stratification for generic and COPD-specific characteristics and, based on multiple physical activity measures, we identified clusters of patients. In total, 1001 patients with COPD (65% men; age, 67 years; forced expiratory volume in the first second [FEV1], 49% predicted) were studied cross-sectionally. Demographics, anthropometrics, lung function and clinical data were assessed. Daily physical activity measures and hourly patterns were analysed based on data from a multisensor armband. Principal component analysis (PCA) and cluster analysis were applied to physical activity measures to identify clusters. Age, body mass index (BMI), dyspnoea grade and ADO index (including age, dyspnoea and airflow obstruction) were associated with physical activity measures and hourly patterns. Five clusters were identified based on three PCA components, which accounted for 60% of variance of the data. Importantly, couch potatoes (i.e. the most inactive cluster) were characterised by higher BMI, lower FEV1, worse dyspnoea and higher ADO index compared to other clusters (p < 0.05 for all). Daily physical activity measures and hourly patterns are heterogeneous in COPD. Clusters of patients were identified solely based on physical activity data. These findings may be useful to develop interventions aiming to promote physical activity in COPD.

International statements have suggested the pulmonary rehabilitation (PR) model as an appropriate rehabilitation option for people recovering from coronavirus disease 2019 (COVID-19). In this case series, we present our COVID-19 telehealth rehabilitation programme, delivered within a PR setting, and discuss the management of our first three cases. All patients were male, with a median age of 73 years. Following hospital discharge, the patients presented with persistent limitations and/or symptoms (e.g. breathlessness, fatigue, and reduced exercise capacity) which warranted community-based rehabilitation. Patients were assessed and provided with an initial six-week rehabilitation programme supported via telehealth using a treatable traits approach. Patients demonstrated improvements in exercise capacity and breathlessness; however, fatigue levels worsened in two cases and this was attributed to the difficulties of managing returning to work and/or carer responsibilities whilst trying to recover from a severe illness. We found that PR clinicians were well prepared and able to provide an individualized rehabilitation programme for people recovering from COVID-19.

Background and objective:In patients with COPD, this study evaluated the effect on health-related quality of life (HRQoL) of adding ongoing feedback to a 12-month unsupervised maintenance walking programme. Methods: Participants were randomized to either an intervention group (IG) or control group (CG). Both groups completed the same 2-month supervised, walking training programme followed by a 12-month unsupervised maintenance walking programme. During the maintenance programme, the IG received ongoing feedback (telephone calls, biofeedback and progressive goal setting) and the CG received no feedback. Results: A total of 75 participants completed the study (mean (SD): age 69 (8) years; forced expiratory volume in 1 s (FEV 1 ) 43 (15) % predicted). There was no between-group differences in the magnitude of change in HRQoL when data collected on completion of the 12-month maintenance programme were compared with that collected either before the 2-month supervised programme (mean between-group difference (MD) in total St George's Respiratory Questionnaire change scores: 1 point, 95% CI: −9 to 7) or on completion of the 2-month supervised programme (MD: 4 points, 95% CI −2 to 10). Conclusion: Following a 2-month supervised walking training programme, ongoing feedback was no more effective than no feedback in maintaining HRQoL during a 12-month unsupervised walking programme.