Long-term effects of outpatient rehabilitation of COPD: A randomized trial.
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.
Güell
R
R
Departament de Pneumologia, Hospital de la Santa Creu i de Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
Casan
P
P
Belda
J
J
Sangenis
M
M
Morante
F
F
Guyatt
G H
GH
Sanchis
J
J
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