title: Long-term effects of outpatient rehabilitation of COPD: A randomized trial.
abstract: OBJECTIVE
  To examine the short- and long-term effects of an outpatient pulmonary rehabilitation program for COPD patients on dyspnea, exercise, health-related quality of life, and hospitalization rate.
  
  
  METHODS
  Secondary-care respiratory clinic in Barcelona.
  
  
  METHODS
  We conducted a randomized controlled trial with blinding of outcome assessment and follow-up at 3, 6, 9, 12, 18, and 24 months. Sixty patients with moderate to severe COPD (age 65 +/- 7 years; FEV(1) 35 +/- 14%) were recruited. Thirty patients randomized to rehabilitation received 3 months of outpatient breathing retraining and chest physiotherapy, 3 months of daily supervised exercise, and 6 months of weekly supervised breathing exercises. Thirty patients randomized to the control group received standard care.
  
  
  RESULTS
  We found significant differences between groups in perception of dyspnea (p < 0.0001), in 6-min walking test distance (p < 0.0001), and in day-to-day dyspnea, fatigue, and emotional function measured by the Chronic Respiratory Questionnaire (p < 0. 01). The improvements were evident at the third month and continued with somewhat diminished magnitude in the second year of follow-up. The PR group experienced a significant (p < 0.0001) reduction in exacerbations, but not the number of hospitalizations. The number of patients needed to treat to achieve significant benefit in health-related quality of life for a 2-year period was approximately three.
  
  
  CONCLUSIONS
  Outpatient rehabilitation programs can achieve worthwhile benefits that persist for a period of 2 years.
authors.affiliation: Departament de Pneumologia, Hospital de la Santa Creu i de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Güell
authors.forename: P
authors.initials: P
authors.lastname: Casan
authors.forename: J
authors.initials: J
authors.lastname: Belda
authors.forename: M
authors.initials: M
authors.lastname: Sangenis
authors.forename: F
authors.initials: F
authors.lastname: Morante
authors.forename: G H
authors.initials: GH
authors.lastname: Guyatt
authors.forename: J
authors.initials: J
authors.lastname: Sanchis
mesh_terms: D000368:Aged; D000553:Ambulatory Care; D001945:Breathing Exercises; D004417:Dyspnea / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011446:Prospective Studies; D011788:Quality of Life; D012129:Respiratory Function Tests; D011795:Surveys and Questionnaires; D016896:Treatment Outcome