Effects of a Home-Based Pulmonary Rehabilitation Program in Patients with Chronic Obstructive Pulmonary Disease in GOLD B Group: A Pilot Study

Abstract

Patients with chronic obstructive pulmonary disease (COPD) in the Global Initiative for Chronic Obstructive Lung Disease (GOLD) B group can be included in pulmonary rehabilitation (PR) settings outside the hospitals. This study aimed to explore the feasibility of a home-based pulmonary rehabilitation (HBPR) program and assess its impact on patients with COPD in the GOLD B group. A real-world, pre–post intervention study was conducted with 12 weeks of HBPR (presential home visits and phone calls) using the self-management program Living Well with COPD. The 1-min sit-to-stand test (1MSTS), modified Medical Research Council Questionnaire (mMRC), COPD Assessment Test (CAT), Hospital Anxiety and Depression Scale (HADS), and London Chest Activity of Daily Living (LCADL) were used to assess the impact. Pre–post differences and correlations between changes in outcomes were calculated. In 30 patients (71.6 years, FEV1 (%) 52.8), significant improvements (p < 0.05) were observed on 1MSTS (Pre 17.2, Post 21.2), mMRC (Pre 2.0, Post 1.0), CAT (Pre 16.3, Post 9.9), HADS (Pre 14.4, Post 9.6), and LCADL (Pre 21.0, Post 15.8), with no adverse events reported. When significant, correlations between changes in outcomes were moderate or strong (0.48 ≤ ρ ≤ 0.66). HBPR can be feasible and safe, and it shows the potential to significantly improve outcomes of patients with COPD in the GOLD B group.

The effects of adding a six-month Pilates exercise program to three months of traditional community-based pulmonary rehabilitation in individuals with COPD: A prospective cohort study

“…48 These metrics, such as the number of chair raises, are important in evaluating the tolerance of fatigue in patients with COPD and have been associated with symptoms such as dyspnea. 49 Improvements in the 6MWD and other related to exercise-induced fatigue are also seen in other studies that implemented pilates in other pathological conditions. 50,51 Likewise, improving balance in patients with COPD is important because impairments and decline in balance are more pronounced in these patients due to exercise intolerance and dyspnea 52,53 as well as other physiological factors such as muscle weakness 54 and somatosensory deficits.…”

Effect of Home-based Pulmonary Rehabilitation Program on Anxiety and Depression in COVID-19 Patients

“…The HBPR studies' benefits especially on HADS are proven previously in COPD patients (43)(44)(45). For example, a study by Vilarinho et al demonstrated that some pulmonary parameters plus HADS scores were improved after HBPR in 30 patients with severe COPD (46). Additionally, Wallaert et al studied HBPR in 112 patients with idiopathic pulmonary fibrosis and fibrotic nonspecific interstitial pneumonitis (47).…”

Reference Equation of a New Incremental Step Test to Assess Exercise Capacity in the Portuguese Adult Population

“…Cardiopulmonary exercise testing (CPET) is considered the gold standard method used to assess exercise capacity, by providing a measure of the maximum oxygen consumption (VO 2 max), which in turn is the gold standard measure for the assessment of cardiorespiratory fitness (CRF) [4]. Treadmills and cycle ergometers are indicated to assess CRF [1]; however, their use is not always feasible in all settings where rehabilitation programs can be implemented [5], especially in community- [6][7][8] and home-based [9][10][11] programs, because they have high costs and require both specialized instruments and trained personnel [1]. To overcome these limitations, field tests can be more affordable, simple to apply, and better related to patients' demands during activities of daily living [2,12].…”