Effects of Home-Based Pulmonary Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Home rehabilitation is a useful, equivalent alternative to outpatient rehabilitation in patients with COPD.

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.…”

“…• Analysis 2: HCPR vs. OPR (a) Functional Capacity: Three studies 36,37,41 (n = 334) assessed functional capacity using the 6MWT. When considered jointly, the interventions did not differ significantly in the distance walked in the 6MWT (8.70m, 95%CI: -6.67 to 24.08, I 2 = 0%) ( Figure 9).…”

How I would manage a man with COPD who has few symptoms and is at low risk of an exacerbation: a primary care perspective from Australia

“…4 He should be encouraged to exercise regularly, and referral to pulmonary rehabilitation will be indicated if his condition deteriorates. 10 Pharmacotherapy for COPD will improve lung function and reduce symptoms but will not prevent long term decline in FEV 1. Options are short-acting bronchodilators on an 'as required' basis, or (if this does not control symptoms) regular longacting antimuscarinics or long-acting β 2-agonists. 2 It is important to educate about device technique and review this together with adherence at follow-up visits.…”

Pulmonary Rehabilitation

“…50; 51 Alternatively, the pulmonary rehabilitation may be conducted in the patient's home; 40 ;52 this may only be feasible if the proper exercise equipment is placed in the home 31 and proper instruction and monitoring is provided. Furthermore, a bottle neck to delivery of rehabilitation in the primary care or home setting is the unavailability of a multidisciplinary team to assess the patient and direct the complex intervention in multi-morbid patients.…”