Costs and benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease: a randomized controlled trial.
OBJECTIVE
The current study evaluated the costs and benefits of a simple aerobic walking program for patients with chronic obstructive pulmonary disease (COPD).


METHODS
This was a blinded randomized controlled clinical trial that recruited 72 patients diagnosed with COPD, 40 of whom were included in the study and divided into two groups [control group (CG) and pulmonary rehabilitation group (GPR)]. We assessed pulmonary function, distance covered during the 6-minute walk test (6MWT), respiratory and peripheral muscle strength, health-related quality of life (HRQOL), body composition, and level of activities of daily living (ADLs) before and after an 8-week walking program. The financial costs were calculated according to the pricing table of the Brazilian Unified Health System (SUS).


RESULTS
Only 34 of the 40 patients remained in the final sample; 16 in the CG and 18 in the GPR (FEV1: 50.9 ± 14% predicted and FEV1: 56 ± 0.5% predicted, respectively). The intervention group exhibited improvements in the 6MWT, sensation of dyspnea and fatigue, work performed, BODE index (p<0.01), HRQOL, ADL level (p<0.001), and lower limb strength (p<0.05). The final mean cost per patient for the GPR was R$ 148.75 (~US$ 75.00) and no patient significantly exceeded this value. However, 2 patients in the CG did exceed this value, incurring a cost of R$ 689.15 (~US$ 345.00).


CONCLUSIONS
Aerobic walking demonstrated significant clinical benefits in a cost-efficient manner in patients with COPD.
Physical Therapy Department, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
Catharinne C
CC
Farias
Physical Therapy Department, Universidade Federal de Pernambuco, Recife, PE, Brazil.
Vanessa
V
Resqueti
Physical Therapy Department, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
Fernando A L
FA
Dias
Physical Therapy Department, Universidade Federal de São Carlos, São Carlos, SP, Brazil.
Audrey
A
Borghi-Silva
Physical Therapy Department, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA.
Ross
R
Arena
Physical Therapy Department, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
Guilherme A F
GA
Fregonezi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003362:Cost-Benefit Analysis; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics* / Q000534:rehabilitation*; D016037:Single-Blind Method; D016138:Walking