title: Clinical benefits of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To evaluate the benefits of home-based pulmonary rehabilitation (PR) in patients with severe and very severe chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Randomized clinical trial involving 58 patients. Pulmonary function, quality of life evaluated by the Saint George Respiratory Questionnaire, breathlessness evaluated by the London Chest Activity of Daily Living Scale, and exercise tolerance evaluated by 6-minute walk distance were assessed at baseline and at 12 weeks. The program consisted of 2 weekly visits by a physiotherapist in the first 2 weeks, followed by visits twice a month, as well as weekly telephone calls. Training included breathing and stretching exercises and strength exercises (upper and lower limbs), along with endurance training, including walking, stair climbing, cycling, and treadmill walking, depending on available patient resources.
  
  
  RESULTS
  The treatment group (TG; n = 23) and control group (CG; n = 18) completed the study. Following the intervention, no statistically significant differences were found in pulmonary function in the TG and CG. The TG exhibited statistically significant differences in the activity domain (P = .008), impact domain (P < .001), and total scores of the Saint George Respiratory Questionnaire (P < .001). In addition, the TG demonstrated statistically significant differences in all domains of the London Chest Activity of Daily Living Scale and no differences were observed in the CG after 12 weeks. There was a statistically significant difference in the 6-Minute Walk Distance in the TG after rehabilitation (P = .008).
  
  
  CONCLUSIONS
  This study offers evidence that home-based PR promotes benefits in the quality of life, breathlessness in activities of daily living, and exercise capacity in patients with severe and very severe COPD. Home-based PR must be considered as part of the treatment for patients who live far from hospitals even in severe COPD.
authors.affiliation: University of Salamanca, Salamanca, Spain (Drs de Sousa Pinto, Martín Nogueras, Arenillas, and González); and University of Fortaleza, Fortaleza, Brazil (Dr de Sousa Pinto).
authors.forename: Juliana M
authors.initials: JM
authors.lastname: de Sousa Pinto
authors.forename: Ana M
authors.initials: AM
authors.lastname: Martín-Nogueras
authors.forename: José I
authors.initials: JI
authors.lastname: Calvo-Arenillas
authors.forename: Jacinto
authors.initials: J
authors.lastname: Ramos-González
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D005080:Exercise Test / Q000379:methods; D005081:Exercise Therapy / Q000379:methods; D017079:Exercise Tolerance; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D011795:Surveys and Questionnaires