Home-based exercise training as maintenance after outpatient pulmonary rehabilitation

BACKGROUND: Pulmonary rehabilitation is successful in improving exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD). However, training effects diminish over time.

OBJECTIVES: We evaluated the effects of simple, daily, structured, self-monitored, home-based exercise training for patients with moderate COPD after a 3-week outpatient rehabilitation.

METHODS: We conducted a randomized, controlled, observer-blind trial. Twenty patients were recruited. Ten patients performed home-based exercise training (mean age 67 years, 95% confidence interval [CI] 63-72; FEV(1) 58.6%, 95% CI 53.8-63.4), and 10 patients served as controls (mean age 72 years, 95% CI 69-77; FEV(1) 62.5%, 95% CI 57.7-67.3). At baseline, and after 3 and 6 months, we assessed exercise capacity (6-min walk test, 6MWT, primary endpoint), health-related quality of life (Chronic Respiratory Questionnaire, CRQ) and lung function. An intention-to-treat analysis was performed using two-way ANOVA models for comparison of time trends between random groups.

RESULTS: The training group had better results than the control group in 6MWT (p = 0.033), in CRQ total (p = 0.027), CRQ dyspnea (p = 0.014) and CRQ fatigue (p = 0.016). Improvement in FEV(1) was also better in the intervention group than in the control group (p = 0.007).

CONCLUSIONS: We demonstrated that training effects obtained from an outpatient rehabilitation program can be maintained by home-based exercise training in patients with moderate COPD.