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Long-term evaluation of home-based pulmonary rehabilitation in patients with COPD.

Grosbois JM, Gicquello A, Langlois C, Le Rouzic O, Bart F, Wallaert B, Chenivesse C - Int J Chron Obstruct Pulmon Dis (2015)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: FormAction Santé, rue Pietralunga, Pérenchies, France ; Service de Pneumologie, CH Béthune, France.

ABSTRACT

Introduction: 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.

Conclusion: 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.

No MeSH data available.


Related in: MedlinePlus

Flowchart showing participation throughout the study of the patients with COPD managed by home-based PR.Abbreviation: PR, pulmonary rehabilitation.
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f1-copd-10-2037: Flowchart showing participation throughout the study of the patients with COPD managed by home-based PR.Abbreviation: PR, pulmonary rehabilitation.

Mentions: The 8-week home-based PR program was proposed to 226 patients with COPD between January 2010 and December 2013 because of disabling dyspnea experienced during activities of daily living, and out of them, 211 patients performed the PR program (Figure 1). The patient gave his or her written consent and chose home-based management on the basis of personal preference and/or the absence of a local PR center. Exclusion criteria were dementia or poorly controlled psychiatric illness, neurological sequelae, or bone and joint diseases preventing physical activity. Patients with diffuse interstitial lung disease (ILD) or lung cancer currently treated by chemotherapy or radiotherapy and the most severely ill patients who had completed a 6-week home-based program with electrostimulation were not included in this study. Patients receiving oxygen therapy and/or noninvasive ventilation (NIV) and/or with multiple stable comorbidities were able to be included in the rehabilitation program. All data were collected prospectively and were entered into our rehabilitation and TPE-computerized medical records. The Comité ďEvaluation des Protocoles de Recherche Observationnelle (CEPRO) (observational research protocol evaluation committee) of the Société de Pneumologie de Langue Française (French Language Society of Pulmonology) (CEPRO 2011-036) examined this project and approved analysis of the data collected from these patients.


Long-term evaluation of home-based pulmonary rehabilitation in patients with COPD.

Grosbois JM, Gicquello A, Langlois C, Le Rouzic O, Bart F, Wallaert B, Chenivesse C - Int J Chron Obstruct Pulmon Dis (2015)

Flowchart showing participation throughout the study of the patients with COPD managed by home-based PR.Abbreviation: PR, pulmonary rehabilitation.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4590573&req=5

f1-copd-10-2037: Flowchart showing participation throughout the study of the patients with COPD managed by home-based PR.Abbreviation: PR, pulmonary rehabilitation.
Mentions: The 8-week home-based PR program was proposed to 226 patients with COPD between January 2010 and December 2013 because of disabling dyspnea experienced during activities of daily living, and out of them, 211 patients performed the PR program (Figure 1). The patient gave his or her written consent and chose home-based management on the basis of personal preference and/or the absence of a local PR center. Exclusion criteria were dementia or poorly controlled psychiatric illness, neurological sequelae, or bone and joint diseases preventing physical activity. Patients with diffuse interstitial lung disease (ILD) or lung cancer currently treated by chemotherapy or radiotherapy and the most severely ill patients who had completed a 6-week home-based program with electrostimulation were not included in this study. Patients receiving oxygen therapy and/or noninvasive ventilation (NIV) and/or with multiple stable comorbidities were able to be included in the rehabilitation program. All data were collected prospectively and were entered into our rehabilitation and TPE-computerized medical records. The Comité ďEvaluation des Protocoles de Recherche Observationnelle (CEPRO) (observational research protocol evaluation committee) of the Société de Pneumologie de Langue Française (French Language Society of Pulmonology) (CEPRO 2011-036) examined this project and approved analysis of the data collected from these patients.

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: FormAction Santé, rue Pietralunga, Pérenchies, France ; Service de Pneumologie, CH Béthune, France.

ABSTRACT

Introduction: 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.

Conclusion: 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.

No MeSH data available.


Related in: MedlinePlus