title: Maintenance after pulmonary rehabilitation in chronic lung disease: a randomized trial.
abstract: Pulmonary rehabilitation is beneficial for patients with chronic lung disease. However, long-term maintenance has been difficult to achieve after short-term treatment. We evaluated a telephone-based maintenance program after pulmonary rehabilitation in 172 patients with chronic lung disease recruited from pulmonary rehabilitation graduates. Subjects were randomly assigned to a 12-month maintenance intervention with weekly telephone contacts and monthly supervised reinforcement sessions (n = 87) or standard care (n = 85) and followed for 24 months. Except for a slight imbalance between sexes, experimental and control groups were equivalent at baseline and showed similar improvements after rehabilitation. During the 12-month intervention, exercise tolerance (maximum treadmill workload and 6-minute walk distance) and overall health status ratings were better maintained in the experimental group together with a reduction in hospital days. There were no group differences for other measures of pulmonary function, dyspnea, self-efficacy, generic and disease-specific quality of life, and health care use. By 24 months, there were no significant group differences. Patients returned to levels close to but above prerehabilitation measures. We conclude that a maintenance program of weekly telephone calls and monthly supervised sessions produced only modest improvements in the maintenance of benefits after pulmonary rehabilitation.
authors.affiliation: Division of Pulmonary and Critical Care Medicine and Department of Family and Preventive Medicine, University of California, San Diego, CA 92103-8377, USA. aries@ucsd.edu
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Ries
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kaplan
authors.forename: Roseann
authors.initials: R
authors.lastname: Myers
authors.forename: Lela M
authors.initials: LM
authors.lastname: Prewitt
mesh_terms: D000359:Aftercare / Q000379:methods*; D000368:Aged; D001294:Attitude to Health; D004417:Dyspnea / Q000209:etiology; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D010359:Patient Readmission / Q000706:statistics & numerical data; D015397:Program Evaluation; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D011788:Quality of Life; D012054:Reinforcement, Psychology; D012129:Respiratory Function Tests; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013689:Telephone