title: Long-term evaluation of home-based pulmonary rehabilitation in patients with COPD.
abstract: BACKGROUND
  Personalized, global pulmonary rehabilitation (PR) management of patients with COPD is effective, regardless of the place in which this rehabilitation is provided. The objective of this retrospective observational study was to study the long-term outcome of exercise capacity and quality of life during management of patients with COPD treated by home-based PR.
  
  
  METHODS
  Home-based PR was administered to 211 patients with COPD (mean age, 62.3±11.1 years; mean forced expiratory volume in 1 second, 41.5%±17.7%). Home-based PR was chosen because of the distance of the patient's home from the PR center and the patient's preference. Each patient was individually managed by a team member once a week for 8 weeks with unsupervised continuation of physical exercises on the other days of the week according to an individual action plan. Exercise conditioning, therapeutic patient education, and self-management were included in the PR program. The home assessment comprised evaluation of the patient's exercise capacity by a 6-minute stepper test, Timed Up and Go test, ten times sit-to-stand test, Hospital Anxiety and Depression score, and quality of life (Visual Simplified Respiratory Questionnaire, VQ11, Maugeri Respiratory Failure 28).
  
  
  RESULTS
  No incidents or accidents were observed during the course of home-based PR. The 6-minute stepper test was significantly improved after completion of the program, at 6 months and 12 months, whereas the Timed Up and Go and ten times sit-to-stand test were improved after PR and at 6 months but not at 12 months. Hospital Anxiety and Depression and quality of life scores improved after PR, and this improvement persisted at 6 months and 12 months.
  
  
  CONCLUSIONS
  Home-based PR for unselected patients with COPD is effective in the short term, and this effectiveness is maintained in the medium term (6 months) and long term (12 months). Home-based PR is an alternative to outpatient management provided all activities, such as exercise conditioning, therapeutic education, and self-management are performed.
authors.affiliation: FormAction Santé, rue Pietralunga, Pérenchies, France ; Service de Pneumologie, CH Béthune, France.
authors.forename: Jean Marie
authors.initials: JM
authors.lastname: Grosbois
authors.affiliation: Service de Pneumologie et Immunoallergologie, Centre des Compétences des Maladies Pulmonaires Rares, Hôpital Calmette, CHRU Lille, France.
authors.forename: Alice
authors.initials: A
authors.lastname: Gicquello
authors.affiliation: Unité de Biostatistiques, CHRU Lille, France.
authors.forename: Carole
authors.initials: C
authors.lastname: Langlois
authors.affiliation: Service de Pneumologie et Immunoallergologie, Centre des Compétences des Maladies Pulmonaires Rares, Hôpital Calmette, CHRU Lille, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Le Rouzic
authors.affiliation: Service de Pneumologie, CH Béthune, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Bart
authors.affiliation: Service de Pneumologie, CH Béthune, France ; Service de Pneumologie et Immunoallergologie, Centre des Compétences des Maladies Pulmonaires Rares, Hôpital Calmette, CHRU Lille, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Wallaert
authors.affiliation: AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale, Boulevard de l'Hôpital, Paris, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Chenivesse
mesh_terms: D000368:Aged; D001007:Anxiety; D015897:Comorbidity; D003863:Depression; D005081:Exercise Therapy / Q000379:methods; D005260:Female; D005541:Forced Expiratory Volume; D018575:Home Care Services, Hospital-Based / Q000592:standards*; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation / Q000592:standards*; D011569:Psychiatric Status Rating Scales; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology* / Q000534:rehabilitation*; D011788:Quality of Life; D012189:Retrospective Studies; D012648:Self Care; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: COPD; anxiety; depression; home; pulmonary rehabilitation; quality of life; self-management