LONG-TERM EFFECTS OF HOME REHABILITATION ON PHYSICAL PERFORMANCE IN CHRONIC OBSTRUCTIVE PULMONARY-DISEASE

A pilot study was set up to assess the long-term effects of once weekl y versus once monthly follow-up of pulmonary rehabilitation after a co mprehensive home rehabilitation program on physical performance in pat ients with chronic obstructive pulmonary disease (COPD) during an 18-m o period. Thirty-six patients with a mean FEV(1) of 1.3 +/- 0.4 L (43% pred) were included in the study. Groups A and B (n = 23) visited the physical therapist twice weekly for 3 mo. Thereafter, 11 patients (Gr oup A) had a follow-up of pulmonary rehabilitation once a week, and 12 patients (Group B) had a follow-up once a month. Thirteen patients re ceived no rehabilitation at all (Group C). Long-term home rehabilitati on does not appear to improve exercise tolerance; however, on the othe r hand, there is a deterioration in vital capacity (p < 0.01), walking distance (p < 0.01), and maximal work load (p < 0.05), as shown in th e control group. A small improvement in exertional dyspnea (p < 0.01) after 18 mo and inspiratory muscle function (p < 0.05) after 12 mo was shown only in Group A. Because of the insufficient number of patients enrolled in this pilot study, no clear benefit on physical performanc e of long-term home rehabilitation with either weekly or monthly super vision could be demonstrated.