title: Low intensity, long-term outpatient rehabilitation in COPD: a randomised controlled trial.
abstract: BACKGROUND
  Most pulmonary rehabilitation programmes currently involve 2-3 sessions per week as recommended by international guidelines. We aimed to investigate whether relevant improvements in physical capabilities and quality of life in patients with chronic obstructive pulmonary disease (COPD) could be achieved by a long-term, low intensity, once weekly rehabilitation programme using limited resources.
  
  
  METHODS
  100 patients with moderate to severe COPD were randomised to a continuous outpatient interdisciplinary rehabilitation programme or standard care. Physiotherapy-led supervised outpatient training sessions were performed once weekly in addition to educational elements. Outcome measures at baseline and after 26 weeks were 6-minute-walk-test, cycle ergometry, and health-related quality of life.
  
  
  RESULTS
  37 patients in the training group and 44 patients in the control group completed the study. After 26 weeks there were clinically significant differences between the groups for 6 minute-walk-distance (+59 m, 95% CI 28-89 m), maximum work load (+7.4 Watt, 95% CI 0.5-13.4 Watt) and St. George's Respiratory Questionnaire score (-5 points, 95% CI -10 to -1 points). Total staff costs of the programme per participant were ≤ €625.
  
  
  CONCLUSIONS
  Clinically meaningful improvements in physical capabilities and health-related quality of life may be achieved using long-term pulmonary rehabilitation programmes of lower intensity than currently recommended.
  
  
  BACKGROUND
  clinicaltrials.gov NCT01195402.
authors.affiliation: Department of Respiratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. hbaumann@uke.uni-hamburg.de
authors.forename: Hans Jörg
authors.initials: HJ
authors.lastname: Baumann
authors.forename: Stefan
authors.initials: S
authors.lastname: Kluge
authors.forename: Katrin
authors.initials: K
authors.lastname: Rummel
authors.forename: Hans
authors.initials: H
authors.lastname: Klose
authors.forename: Jan K
authors.initials: JK
authors.lastname: Hennigs
authors.forename: Tibor
authors.initials: T
authors.lastname: Schmoller
authors.forename: Andreas
authors.initials: A
authors.lastname: Meyer
mesh_terms: D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000628:therapy*; D011788:Quality of Life; D020127:Recovery of Function; D012129:Respiratory Function Tests; D016896:Treatment Outcome