Article

PURPOSE: 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.

Langue : ANGLAIS

Tiré à part : OUI