Benefits of a Home-Based Pulmonary Rehabilitation Program for Patients With Severe Chronic Obstructive Pulmonary Disease

Home or community-based pulmonary rehabilitation for individuals with chronic obstructive pulmonary disease: a systematic review and meta-analysis

“…Of these, 58 were considered potentially relevant and 23 studies 17,18,19,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50 met the eligibility criteria and were included in this review. One of the selected studies appeared in two distinct publications 49,50 in which the same intervention was applied to the same patients but describing different outcomes.…”

“…Thirteen studies were done in Europe 17,19,21,31,33,38,42,43,45,46,48,49,50 , six in Asia 30,36,39,40,44,47 , two in Australasia 34,35 , one in North America 41 , and one in South America 32 . Among the studies included in the review, 19 17,18,19,30,31,32,33,34,36,38,39,40,42,43,44,46,47,48,49,50 compared HCPR to control group (n = total 893; n HCPR = 485), while four 35,37,41,45 compared HCPR to OPR (n total = 375; n HCPR = 178). No studies reported harmful effects related to HCPR during interventions.…”

“…Four studies 19,38,43,48 (n = 280) evaluated dyspnea using the MRC. The meta-analysis indicated significant improvement in the 6MWT (33.79 meters, 95%CI: 6.03 to 61.54, I 2 = 76%), but due to the high heterogeneity, a subgroup analysis was done on studies including patients with FEV 1 above and below 50% of predicted.…”

“…Finally, there was a significant decrease in sensation of dyspnea assessed by MRC in HCPR compared to controls (-0.21, 95%CI: -0.42 to -0.00, I 2 = 0%) ( Figure 6). (b) Quality of Life: Thirteen studies 17,18,19,31,33,34,36,38,42,44,46,47,49 (n = 521) assessed quality of life with CRQ and four 18,30,39,48 (n = 281) with SGRQ. The meta-analysis showed that participants who received the intervention showed significant improvement in the four quality of life domains as- Figure 3 Graph on risk of bias for each selected study.…”

“…Some studies (including randomized clinical trials, RCTs) on the use of PR as home or community-based pulmonary rehabilitation (HCPR) rather than in an outpatient clinical setting (OPR) show positive results in improving exercise capacity and quality of life and a decreasing dyspnea sensation 17,18,19,20 . We defined HCPR as a PR program developed in a non-specialized community health service, in a community center, or at the patient's home.…”