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

Aim: In this study, the effects of a 12-week hospital-based outpatient pulmonary rehabilitation program (HRP) are compared with those of a 1 2-week homecare rehabilitation program (HCRP) in COPD patients. A cont rol group received no rehabilitation therapy. Methods: After randomiza tion and stratification, effects on lung function, exercise performanc e (4-min walking test and cycle ergometer test), dyspnea, and leg effo rt during exercise, and well-being were assessed in 45 COLD patients w ith moderate to severe airflow limitation (mean [SD] FEV(1) percent pr edicted, 42.8 [8.4]). Results: After HRP and HCRP, at 3 to 6 months af ter the start of the study, equal improvements were detected in exerci se capacity and in Borg dyspnea and leg effort scores at similar work levels during the cycle test. However, whereas after HRP at longer ter m values tended to return to baseline outcome, after HCRP a further on going significant improvement in exercise capacity was observed, while Borg dyspnea scores remained significantly improved over 18 months. I mprovements in cycle workload and dyspnea score were significantly bet ter maintained after HCRP as compared with HRP. Lung function, arteria l oxygen saturation, and heart frequency during exercise did not chang e. A significant improvement in well-being was maintained over 18 mont hs in both rehabilitation groups. Conclusion: Beneficial effects are a chieved both after a HRP and a HCRP in COPD patients with moderate to severe ail-flow limitation. Yet we recommend to initiate HCRPs as impr ovements are maintained longer and are even further strengthened in th is setting.