title: Home or community-based pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis.
abstract: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide, and outpatient pulmonary rehabilitation (OPR) has shown positive results. The aim of this study was to investigate the effects of home or community-based pulmonary rehabilitation (HCPR) in individuals with COPD. This systematic review and meta-analysis of randomized clinical trials compared HCPR to controls and HCPR to OPR according to functional capacity, dyspnea, and quality of life in individuals with COPD. 3,172 citations were identified in databases, and 23 were included in this review. HCPR proved superior to controls based on functional capacity in the 6-Minute Walk Test and Incremental Shuttle Walk Test, and based on dyspnea and quality of life in the Saint George's Respiratory Questionnaire and the Chronic Respiratory Questionnaire. When HCPR and OPR were compared, there were no effect differences in functional capacity or quality of life. Improvement was greater in patients with more bronchial obstruction measured by FEV1. HCPR improves functional capacity and quality of life and decreases the sensation of dyspnea. Its benefits in functional capacity and quality of life are comparable to those obtained with OPR in individuals with COPD.
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, Brasil., Universidade do Vale do Rio dos Sinos, Universidade do Vale do Rio dos Sinos, São Leopoldo , Brazil.
authors.forename: Leonardo Fratti
authors.initials: LF
authors.lastname: Neves
authors.affiliation: Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Brasil., Universidade Federal de Ciências da Saúde de Porto Alegre, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre , Brazil.
authors.forename: Manoela Heinrichs Dos
authors.initials: MH
authors.lastname: Reis
authors.affiliation: Universidade do Vale do Rio dos Sinos, São Leopoldo, Brasil., Universidade do Vale do Rio dos Sinos, Universidade do Vale do Rio dos Sinos, São Leopoldo , Brazil.
authors.forename: Tonantzin Ribeiro
authors.initials: TR
authors.lastname: Gonçalves
mesh_terms: D016022:Case-Control Studies; D004417:Dyspnea / Q000503:physiopathology / Q000534:rehabilitation; D006701:Home Nursing; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D011788:Quality of Life