title: Minimally supervised home rehabilitation improves exercise capacity and health status in patients with COPD.
abstract: OBJECTIVE
  The purpose of this study was to investigate the effects on exercise tolerance and quality of life of an outpatient rehabilitation program implemented at home without a physiotherapist's direct supervision in patients with chronic obstructive lung disease.
  
  
  METHODS
  Patients with moderate chronic obstructive pulmonary disease were studied. The rehabilitation program included lower limb exercise on a stationary bicycle and upper limb exercise and stretching, together with education, and it lasted for 12 wks. Every 2 wks, a physiotherapist contacted patients by phone to evaluate their compliance with the rehabilitation program and any adverse effects. The main measures of outcome were the Health Status Index, cycle ergometer test, forced expiratory volume in 1 sec, and forced vital capacity. Patients were evaluated at the baseline and at 12 wks.
  
  
  RESULTS
  A total of 32 patients were recruited and 28 (mean age, 70.4 yrs) completed the trial. After pulmonary rehabilitation, a significant improvement was found in seven of the nine Health Status Index quality-of-life subscales. Exercise tolerance also improved significantly, whereas no variation was observed in pulmonary function tests. There was no correlation between the improvement in quality of life and the improvement in exercise tolerance. The improvements in the Health Status Index physical function and general health subscales correlated negatively with forced expiratory volume in 1 sec (percentage of predicted value) and positively with residual volume/total lung capacity ratio. The improvement in exercise tolerance (expressed in watts or as maximum oxygen uptake), but not in quality-of-life indexes, was associated negatively with age and positively with weight, cognitive function, and forced expiratory volume in 1 sec/forced vital capacity ratio.
  
  
  CONCLUSIONS
  We conclude that an inexpensive home rehabilitation program can improve quality of life and exercise tolerance in patients with moderate chronic obstructive pulmonary disease. Furthermore, our results indicate that exercise tolerance evaluated by cycloergometry and quality of life evaluated by the mean of the Health Status Index questionnaire are independent outcome measures of pulmonary rehabilitation.
authors.affiliation: Dipartimento di Scienze Biomediche e Chirurgiche, Servizio di Fisiopatologia Respiratoria, Università di Verona, Verona, Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Ferrari
authors.forename: Antonella
authors.initials: A
authors.lastname: Vangelista
authors.forename: Ermes
authors.initials: E
authors.lastname: Vedovi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Falso
authors.forename: Carlo
authors.initials: C
authors.lastname: Segattini
authors.forename: Emanuele
authors.initials: E
authors.lastname: Brotto
authors.forename: Bruno
authors.initials: B
authors.lastname: Brigo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Lo Cascio
mesh_terms: D000368:Aged; D005081:Exercise Therapy; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005541:Forced Expiratory Volume; D006304:Health Status; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life