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A Comparison Between an Outpatient Hospital-Based Pulmonary Rehabilitation Program and a Home-Care Pulmonary Rehabilitation Program in Patients With COPD : A Follow-up of 18 Months FREE TO VIEW

Jaap H. Strijbos; Dirkje S. Postma; Richard van Altena; Fernando Gimeno; Gerard H. Koëter
Author and Funding Information

Affiliations: From the Department of Pulmonary Diseases, University Hospital, Groningen, the Netherlands,  From the Asthma Centre Beatrixoord, Haren, the Netherlands

Affiliations: From the Department of Pulmonary Diseases, University Hospital, Groningen, the Netherlands,  From the Asthma Centre Beatrixoord, Haren, the Netherlands


1996 BY THE AMERICAN COLLEGE OF CHEST PHYSICIANS


Chest. 1996;109(2):366-372. doi:10.1378/chest.109.2.366
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Abstract

Aim: In this study, the effects of a 12-week hospital-based outpatient pulmonary rehabilitation program (HRP) are compared with those of a 12-week homecare rehabilitation program (HCRP) in COPD patients. A control group received no rehabilitation therapy.

Methods: After randomization and stratification, effects on lung function, exercise performance (4-min walking test and cycle ergometer test), dyspnea, and leg effort during exercise, and well-being were assessed in 45 COPD patients with moderate to severe airflow limitation (mean [SD] FEV1 percent predicted, 42.8 [8.4]).

Results: After HRP and HCRP, at 3 to 6 months after the start of the study, equal improvements were detected in exercise capacity and in Borg dyspnea and leg effort scores at similar work levels during the cycle test. However, whereas after HRP at longer term values tended to return to baseline outcome, after HCRP a further ongoing significant improvement in exercise capacity was observed, while Borg dyspnea scores remained significantly improved over 18 months. Improvements in cycle workload and dyspnea score were significantly better maintained after HCRP as compared with HRP. Lung function, arterial oxygen saturation, and heart frequency during exercise did not change. A significant improvement in well-being was maintained over 18 months in both rehabilitation groups.

Conclusion: Beneficial effects are achieved both after a HRP and a HCRP in COPD patients with moderate to severe airflow limitation. Yet we recommend to initiate HCRPs as improvements are maintained longer and are even further strengthened in this setting.


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