Low intensity, long-term outpatient rehabilitation in COPD: a randomised controlled trial
1 Department of Respiratory Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
2 Department of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
3 Pulmonary practice Winterhude, Hamburg, Germany
4 Kliniken Mariahilf GmbH, Department of Pneumology, Mönchengladbach, Germany
Respiratory Research 2012, 13:86 doi:10.1186/1465-9921-13-86Published: 27 September 2012
Most pulmonary rehabilitation programmes currently involve 2–3 sessions per week as recommended by international guidelines. We aimed to investigate whether relevant improvements in physical capabilities and quality of life in patients with chronic obstructive pulmonary disease (COPD) could be achieved by a long-term, low intensity, once weekly rehabilitation programme using limited resources.
100 patients with moderate to severe COPD were randomised to a continuous outpatient interdisciplinary rehabilitation programme or standard care. Physiotherapy-led supervised outpatient training sessions were performed once weekly in addition to educational elements. Outcome measures at baseline and after 26 weeks were 6-minute-walk-test, cycle ergometry, and health-related quality of life.
37 patients in the training group and 44 patients in the control group completed the study. After 26 weeks there were clinically significant differences between the groups for 6 minute-walk-distance (+59 m, 95% CI 28–89 m), maximum work load (+7.4 Watt, 95% CI 0.5-13.4 Watt) and St. George’s Respiratory Questionnaire score (−5 points, 95% CI −10 to −1 points). Total staff costs of the programme per participant were ≤ €625.
Clinically meaningful improvements in physical capabilities and health-related quality of life may be achieved using long-term pulmonary rehabilitation programmes of lower intensity than currently recommended. Trial registration: clinicaltrials.gov NCT01195402.