title: [Home vs hospital-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: a Spanish multicenter trial].
abstract: OBJECTIVE
  To compare the effects of a simple home pulmonary rehabilitation program and an intensive hospital-based program in terms of the exercise tolerance and health-related quality of life (HRQL) of patients with severe chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Patients in this prospective, multicenter trial were randomized to 2 groups to receive hospital or home pulmonary rehabilitation. Patients in both groups attended 2 informative sessions about the disease and 4 physical therapy sessions. Patients in the hospital group then carried out a structured exercise program while home group patients performed low intensity exercises at home without supervision.
  
  
  RESULTS
  Twenty-eight patients were randomized to the hospital rehabilitation group and 23 to the home group. Both groups showed a similar improvement on the 6-minute walk test (mean difference, 8.7 m; P=.61). HRQOL measured with the Chronic Respiratory Questionnaire also improved in both groups, but the change was greater on the emotional function domain in the hospital rehabilitation group (mean difference between groups, 0.58 on a scale for which the smallest clinically relevant difference is 0.5 points). The benefits were maintained in both groups 6 months after the programs ended.
  
  
  CONCLUSIONS
  This study demonstrates that the improvement in exercise tolerance achieved by COPD patients with an unsupervised home pulmonary rehabilitation program is similar to the gains of patients in an intensive hospital-based program. However, the hospital program afforded greater benefit on the HRQOL emotional function domain.
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Barcelona, España. mguellr@santpau.es
authors.forename: María Rosa
authors.initials: MR
authors.lastname: Güell
authors.forename: Pilar
authors.initials: P
authors.lastname: de Lucas
authors.forename: Juan Bautista
authors.initials: JB
authors.lastname: Gáldiz
authors.forename: Teodoro
authors.initials: T
authors.lastname: Montemayor
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Rodríguez González-Moro
authors.forename: Amaia
authors.initials: A
authors.lastname: Gorostiza
authors.forename: Francisco
authors.initials: F
authors.lastname: Ortega
authors.forename: José M
authors.initials: JM
authors.lastname: Bellón
authors.forename: Gordon
authors.initials: G
authors.lastname: Guyatt
mesh_terms: D000368:Aged; D006699:Home Care Services; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D013030:Spain