Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial

Abstract

IntroductionPulmonary rehabilitation (PR) is a multidisciplinary program of care for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving the functional capacity and quality of life, as well as maintaining the clinical stability of COPD sufferers. However, not all patients are available for such a program despite discomfort with their condition. The aim of this study was to evaluate the effects of a home-based PR (HBPR) program on functional ability, quality of life, and respiratory muscle strength and endurance.Patients and methodsPatients with COPD according to the Global Initiative of Chronic Obstructive Lung Disease were randomized (double-blind) into two groups. One group performed a protocol at home with aerobic and muscle strength exercises and was called the intervention group; the other group received only instructions to perform breathing and stretching exercises, characterizing it as the control group (CG). We assessed the following variables at baseline and 2 months: exercise tolerance (incremental shuttle walk test and upper limb test), respiratory muscle (strength and endurance test), and health-related quality of life (Airways Questionnaire 20).ResultsThere were no significant changes after the intervention in either of the two groups in exercise tolerance and quality of life. However, the intervention group had improved respiratory endurance compared with the CG, while the CG presented a decrease in the load sustained by the respiratory muscles after the HBPR.ConclusionA program of HBPR with biweekly supervision (although not enough to provide significant improvements in physical capacity or quality of life) played an important role in maintaining the stability of the clinical features of patients with COPD; the patients had no worsening of symptoms during the intervention period according to the daily log.

Home or community-based pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis

“…Of these, 58 were considered potentially relevant and 23 studies 17,18,19,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50 met the eligibility criteria and were included in this review. One of the selected studies appeared in two distinct publications 49,50 in which the same intervention was applied to the same patients but describing different outcomes.…”

“…Thirteen studies were done in Europe 17,19,21,31,33,38,42,43,45,46,48,49,50 , six in Asia 30,36,39,40,44,47 , two in Australasia 34,35 , one in North America 41 , and one in South America 32 . Among the studies included in the review, 19 17,18,19,30,31,32,33,34,36,38,39,40,42,43,44,46,47,48,49,50 compared HCPR to control group (n = total 893; n HCPR = 485), while four 35,37,41,45 compared HCPR to OPR (n total = 375; n HCPR = 178). No studies reported harmful effects related to HCPR during interventions.…”

“…• Analysis 1: HCPR vs. control group (a) Functional Capacity and Dyspnea: Ten studies 30,31,33,36,40,44,46,47,48,50 (n = 461) assessed functional capacity with the 6MWT and seven used the ISWT 18,32,34,38,39,42,43 (n = 321). Four studies 19,38,43,48 (n = 280) evaluated dyspnea using the MRC.…”

Effects of Inspiratory Muscle Training and Calisthenics-and-Breathing Exercises in COPD With and Without Respiratory Muscle Weakness

“…Such a protocol has already been described in a study by Dias et al 22 For both tests, a breathing pattern was not fixed, but the respiratory rate was constantly monitored and recorded. 21 The tests were considered finished when the subject could not generate the determined load in 3 successive attempts or spontaneously, due to dyspnea and/or fatigue.…”

Reabilitação Domiciliar Com Exercício Não Supervisionado Na Dpoc: Revisão Sistemática

“…Dos trabalhos analisados, seis compararam o grupo intervenção que participou de um programa de reabilitação não supervisionado (GRNS) com um controle (GC) que não realizou exercício 8,10,[12][13][14][15][16] , enquanto três estudos fizeram a comparação com um grupo controle que participou de reabilitação supervisionada no ambiente ambulatorial (GRS) [17][18][19] . A Tabela 1 apresenta a pontuação dos oito estudos enfocando en particular los beneficios relacionados con la calidad de vida y la disnea; no se pudo identificar mejoría en otros resultados.…”