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The impact of home-based pulmonary rehabilitation on people with mild chronic obstructive pulmonary disease: a randomised controlled trial

Lahham, A ORCID: 0000-0003-2090-0746, McDonald, CF, Moore, R, Cox, NS, Rawlings, S, Nichols, A, Liacos, A and Holland, AE 2020 , 'The impact of home-based pulmonary rehabilitation on people with mild chronic obstructive pulmonary disease: a randomised controlled trial' , The Clinical Respiratory Journal, vol. 14, no. 4 , pp. 335-344 , doi: 10.1111/crj.13138.

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Abstract

Introduction: People with mild chronic obstructive pulmonary disease (COPD) experience exercise intolerance, dyspnoea and poor quality of life. However, the role of pulmonary rehabilitation (PR) in this group is unclear. Objectives: This randomised controlled trial aimed to explore the effects of home-based PR in people with mild COPD. Methods: People with mild COPD (FEV1/FVC 1 > 80%predicted) with a smoking history of ≥10 packet years were randomised to either 8 weeks of home-based PR (one home visit and seven once-weekly telephone calls) or standard care (weekly social telephone calls). Six minute walk distance (6MWD), and Modified Medical Research Council Dyspnoea Scale (mMRC) and Chronic Respiratory Disease Questionnaire (CRQ) scores were compared. Results: A total of 58 participants (34 males, mean age 68 (SD 9) years, FEV1%predicted 90 (7), 6MWD 496 (105) m) were included with 31 participants randomised to home-based PR. Participants attended an average of 6.8 of the 8 scheduled sessions, ranging from 3 to 8 sessions. Both groups showed improvements in exercise capacity, symptoms and health-related quality of life (HRQoL) over time, however there was no difference in 6MWD at end-intervention (mean difference -3 m, 95% confidence interval (CI) -64 to 58) or 6 months (7 m, 95% CI -59 to 72). At 6 months home-based PR participants were more likely to have clinically important improvements in CRQ emotional function (50% of home PR vs 0% control, P P = 0.05). Conclusion: For people with mild COPD, home-based PR did not improve exercise capacity more than standard care.

Item Type: Article
Authors/Creators:Lahham, A and McDonald, CF and Moore, R and Cox, NS and Rawlings, S and Nichols, A and Liacos, A and Holland, AE
Keywords: chronic obstructive pulmonary disease, home care services, pulmonary rehabilitation
Journal or Publication Title: The Clinical Respiratory Journal
Publisher: Wiley-Blackwell Publishing, Inc.
ISSN: 1752-699X
DOI / ID Number: 10.1111/crj.13138
Copyright Information:

Copyright 2019 John Wiley & Sons Ltd

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