title: Efficacy of pulmonary rehabilitation in patients with moderate chronic obstructive pulmonary disease: a randomized controlled trial.
abstract: BACKGROUND
  Pulmonary Rehabilitation for moderate Chronic Obstructive Pulmonary Disease in primary care could improve patients' quality of life.
  
  
  METHODS
  This study aimed to assess the efficacy of a 3-month Pulmonary Rehabilitation (PR) program with a further 9 months of maintenance (RHBM group) compared with both PR for 3 months without further maintenance (RHB group) and usual care in improving the quality of life of patients with moderate COPD.We conducted a parallel-group, randomized clinical trial in Majorca primary health care in which 97 patients with moderate COPD were assigned to the 3 groups. Health outcomes were quality of life, exercise capacity, pulmonary function and exacerbations.
  
  
  RESULTS
  We found statistically and clinically significant differences in the three groups at 3 months in the emotion dimension (0.53; 95%CI0.06-1.01) in the usual care group, (0.72; 95%CI0.26-1.18) the RHB group (0.87; 95%CI 0.44-1.30) and the RHBM group as well as in fatigue (0.47; 95%CI 0.17-0.78) in the RHBM group. After 1 year, these differences favored the long-term rehabilitation group in the domains of fatigue (0.56; 95%CI 0.22-0.91), mastery (0.79; 95%CI 0.03-1.55) and emotion (0.75; 95%CI 0.17-1.33). Between-group analysis only showed statistically and clinically significant differences between the RHB group and control group in the dyspnea dimension (0.79 95%CI 0.05-1.52). No differences were found for exacerbations, pulmonary function or exercise capacity.
  
  
  CONCLUSIONS
  We found that patients with moderate COPD and low level of impairment did not show meaningful changes in QoL, exercise tolerance, pulmonary function or exacerbation after a one-year, community based rehabilitation program. However, long-term improvements in the emotional, fatigue and mastery dimensions (within intervention groups) were identified.
  
  
  BACKGROUND
  ISRCTN94514482.
authors: Primary Care Majorca Department, Son Pisà Primary Health Centre, C/ Vicenç Joan Perello Ribes, 65, Palma de Mallorca, Baleares, Spain. miguelroman@ibsalut.caib.es
authors: Miguel
authors: M
authors: Román
authors: Concepción
authors: C
authors: Larraz
authors: Amalia
authors: A
authors: Gómez
authors: Joana
authors: J
authors: Ripoll
authors: Isabel
authors: I
authors: Mir
authors: Eduardo Z
authors: EZ
authors: Miranda
authors: Ana
authors: A
authors: Macho
authors: Vicenç
authors: V
authors: Thomas
authors: Magdalena
authors: M
authors: Esteva
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D018450:Disease Progression; D004417:Dyspnea / Q000209:etiology / Q000534:rehabilitation; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005221:Fatigue / Q000209:etiology / Q000534:rehabilitation; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D014797:Vital Capacity; D016138:Walking / Q000502:physiology
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