The cost/benefits of outpatient-based pulmonary rehabilitation.
OBJECTIVE
To evaluate the outcomes of an inexpensive outpatient pulmonary rehabilitation program for stable patients with chronic obstructive pulmonary disease (COPD).


METHODS
Before-and-after trial.


METHODS
Private, ambulatory setting with carryover to the home.


METHODS
Forty-six stable COPD patients, from 45 to 80 years of age.


METHODS
A pulmonary rehabilitation program consisting of education, training, group therapy, and an individualized regimen of home-based extremity and inspiratory muscle exercise with weekly ambulatory sessions over a 10-week period.


METHODS
Symptom-limited oxygen consumption (SLVO2), distance walked in 12 minutes (12 MW), dyspnea, endurance, forced expiratory volumes, minute ventilation (MV), changes in heart rate and blood pressure, and inspiratory muscle work tolerance (IMWT).


RESULTS
There were significant increases (p < .05) in SLVO2, 12 MW, inspiratory muscle and bicycle work capacity, and forced vital capacity (FVC). The sensation of dyspnea significantly decreased during the performance of activities of daily living (ADL) (p < .05). There was no significant change in forced expiratory volume in 1 second (FEV1). The cost of the 10 outpatient sessions was $650.


CONCLUSIONS
An inexpensive outpatient/home-based pulmonary rehabilitation program provided largely by a specifically trained therapist under physician supervision can significantly improve parameters associated with quality of life for patients with COPD.
Reina-Rosenbaum
R
R
Department of Physical Medicine and Rehabilitation, UMDNJ-New Jersey Medical School, Newark, USA.
Bach
J R
JR
Penek
J
J
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000191:economics*; D001945:Breathing Exercises; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000191:economics* / Q000503:physiopathology / Q000534:rehabilitation*; D008875:Middle Aged; D010353:Patient Education as Topic; D012129:Respiratory Function Tests; D016896:Treatment Outcome