<p>Long-Term Effectiveness of a Home-Based Pulmonary Rehabilitation in Older People with Chronic Obstructive Pulmonary Disease: A Retrospective Study</p>

Abstract

Background: Long-term effectiveness of pulmonary rehabilitation (PR) is still uncertain in older people with severe chronic obstructive pulmonary disease (COPD). The objective was to compare the effects of home-based PR in people with COPD above and below the age of 70 years. Methods: In this retrospective study, 480 people with COPD were recruited and divided into those ≤70 (n=341) and those >70 years of age (n=139). All participants underwent an 8 weeks of home-based PR, consisting of a weekly supervised 90-minute home session. Sixminute stepper test (6MST), timed-up and go test (TUG), Hospital Anxiety and Depression Scale, and Visual Simplified Respiratory Questionnaire (VSRQ) were assessed at baseline (M0), at 2 (M2), 8 (M8), 14 (M14) months after baseline. Results: The older group was described by fewer current smokers (p <0.001), more longterm oxygen therapy use (p = 0.024), higher prevalence of comorbidities (p<0.001), lower 6MST score and higher TUG score (p<0.001), compared to the younger group. Both groups improved every outcome at M2 compared to baseline. At M2, 88% of people ≤70 years of age and 79% of those above 70 were considered as responders in at least one evaluated parameter (p = 0.013). Both groups maintained the benefits at M14, except for the VSRQ score and the number of responders to this outcome in the older group. Conclusion: Regardless of the age, personalized home-based PR was effective for people with COPD in the short term. Above 70 years, an ageing effect appeared on the long-term effectiveness of quality of life benefit.

Feasibility, safety and effectiveness of remote pulmonary rehabilitation during COVID-19 pandemic

“…This brief report shows that 8 weeks of PR, combining supervised home visits and telehealthcare, was feasible, safe and effective for improving exercise tolerance, quality of life, anxiety, depression and fatigue score in patients with CRD. We also raised important points to consider: i) the majority of participants (74.7%) only had access to phone calls for telehealthcare; ii) the number of patients who stopped or declined PR after the first session (12.4%) was higher than a previous result (2.9%) [5], but the number of PR non-completers was similar (8.6% vs. 7.6%) [3]; iii) the pandemic prevented 32.5% of participants from having the physical assessments at home (6MST); iiii) PR was pursued by reducing the number of face-to-face visits and by following health recommendations.…”

“…We retrospectively included all participants that were referred to the 8-week home-based PR program, without other specific criteria than those previously described [3][4][5]. Details regarding the ethical approval, informed consent of participants, and PR program can be found elsewhere [3][4][5].…”

“…We retrospectively included all participants that were referred to the 8-week home-based PR program, without other specific criteria than those previously described [3][4][5]. Details regarding the ethical approval, informed consent of participants, and PR program can be found elsewhere [3][4][5]. The program included an initial educational needs assessment, performed at home or by telehealthcare after March 17, followed by a home visit to provide training equipment, supervise the first exercise session and perform the evaluations.…”

Effectiveness of Non-Presential Individualized Exercise Training PrOgram(NIETO) in Lower Limb Physical Performance in Advanced COPD

“…For this reason, the NIETO program acquires special relevance due to its home approach and because it shows a positive effect on the performance of the lower limbs in a population of patients with advanced COPD with severe physical limitations. New prospective studies should confirm these findings, with similar approaches and simple assessment tools, incorporating necessary aspects such as the cost-effectiveness of home-based RP programs [ 62 , 63 , 64 ].…”