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Real-life feasibility and effectiveness of home-based pulmonary rehabilitation in chronic obstructive pulmonary disease requiring medical equipment

2017; Dove Medical Press; Volume: Volume 12; Linguagem: Inglês

10.2147/copd.s150827

1178-2005

Jérémy Coquart, Olivier Le Rouzic, Ghazi Racil, B. Wallaert, Jean‐Marie Grosbois,

Asthma and respiratory diseases

Background: Pulmonary rehabilitation (PR) is a key treatment of chronic obstructive pulmonary disease (COPD) but studies are still needed to identify the most pertinent criteria to personalize this intervention and improve its efficacy. Objective: This real-life retrospective study compared the effects of home-based PR on exercise tolerance, anxiety, depression, and health-related quality of life (HRQoL) in COPD patients, according to their medical equipment. Methods: Exercise tolerance, anxiety, depression, and HRQoL were evaluated in 109 patients equipped with long-term oxygen therapy (LTOT), 84 patients with noninvasive ventilation (NIV), 25 patients with continuous positive airway pressure (CPAP), and 80 patients with no equipment (NE), before, just after, and 6 and 12 months after PR. Results: At baseline, the body mass index in the CPAP and NIV groups was higher ( p <0.05) than in the other two groups, and the forced expiratory volume in 1 second was lower in the LTOT and NIV groups ( p <0.001). All parameters improved after PR in the four groups ( p <0.05), but for exercise tolerance, only the 6-minute stepper test showed maintained improvement after 6 and 12 months, whereas the 10 times sit-to-stand and timed up-and-go tests were only improved just after PR. At every time point, exercise tolerance was lower in the LTOT group ( p <0.05), with a similar trend in the NIV group. Conclusion: Despite differences in the medical equipment to treat COPD, home-based PR showed comparable feasibility, safety, and efficacy in all equipment-based groups. Medical equipment should therefore not be a barrier to home-based PR. Keywords: personalized medicine, noninvasive ventilation, long-term oxygen therapy, continuous positive airway pressure