title: Pulmonary rehabilitation maintenance interventions: a systematic review.
abstract: OBJECTIVE
  To examine existing research on pulmonary exercise rehabilitation (PR) maintenance interventions.
  
  
  METHODS
  Authors conducted a systematic review of PR maintenance interventions. The primary outcome of interest was physical endurance.
  
  
  RESULTS
  Eight studies met inclusion criteria. Most showed initial positive intervention effects, which declined to non-significance within 3-12 months after completion of maintenance. Only one of the 8 studies described a theoretical framework underlying the maintenance intervention.
  
  
  CONCLUSIONS
  Existing interventions generally fail to maintain benefits derived from PR programs. Future studies should evaluate maintenance interventions that are theoretically-based and seek to impact known maintenance mediators. Evaluation of these interventions should include substantial follow-up periods and adherence measurements.
authors.affiliation: Emergency Service, VA Boston Healthcare System, Boston, MA, USA; Lifespan Physician Group, Behavioral Medicine Clinical Services, The Miriam Hospital, Providence, RI, USA. abusby@lifespan.org.
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Busby
authors.affiliation: Behavioral Medicine fellow, Behavioral Medicine Service, VA Boston Healthcare System, Boston, MA, USA.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Reese
authors.affiliation: Chief, Section of General Internal Medicine, VA Boston Healthcare System, Boston, MA, USA.
authors.forename: Steven R
authors.initials: SR
authors.lastname: Simon
mesh_terms: D015982:Bias; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D010349:Patient Compliance; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*