Home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized clinical trial.
BACKGROUND
Pulmonary rehabilitation (PR) is a multidisciplinary program of care for patients with chronic obstructive pulmonary disease (COPD) with the goal of improving the functional capacity and quality of life, as well as maintaining the clinical stability of COPD sufferers. However, not all patients are available for such a program despite discomfort with their condition. The aim of this study was to evaluate the effects of a home-based PR (HBPR) program on functional ability, quality of life, and respiratory muscle strength and endurance.


METHODS
Patients with COPD according to the Global Initiative of Chronic Obstructive Lung Disease were randomized (double-blind) into two groups. One group performed a protocol at home with aerobic and muscle strength exercises and was called the intervention group; the other group received only instructions to perform breathing and stretching exercises, characterizing it as the control group (CG). We assessed the following variables at baseline and 2 months: exercise tolerance (incremental shuttle walk test and upper limb test), respiratory muscle (strength and endurance test), and health-related quality of life (Airways Questionnaire 20).


RESULTS
There were no significant changes after the intervention in either of the two groups in exercise tolerance and quality of life. However, the intervention group had improved respiratory endurance compared with the CG, while the CG presented a decrease in the load sustained by the respiratory muscles after the HBPR.


CONCLUSIONS
A program of HBPR with biweekly supervision (although not enough to provide significant improvements in physical capacity or quality of life) played an important role in maintaining the stability of the clinical features of patients with COPD; the patients had no worsening of symptoms during the intervention period according to the daily log.
Post Graduate Program in Rehabilitation Sciences, Nove de Julho University - UNINOVE, São Paulo, Brazil.
Fernanda Dultra
FD
Dias
Luciana Maria Malosá
LM
Sampaio
Graziela Alves
GA
da Silva
Évelim L F Dantas
ÉL
Gomes
Eloisa Sanches Pereira
ES
do Nascimento
Vera Lucia Santos
VL
Alves
Roberto
R
Stirbulov
Dirceu
D
Costa
D000368:Aged; D001938:Brazil; D001945:Breathing Exercises; D004311:Double-Blind Method; D005081:Exercise Therapy; D017079:Exercise Tolerance; D005260:Female; D018575:Home Care Services, Hospital-Based; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D052580:Muscle Stretching Exercises; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D020127:Recovery of Function; D012132:Respiratory Muscles / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome
COPD; home-based pulmonary rehabilitation; shuttle walk test