RANDOMIZED CONTROLLED TRIAL OF RESPIRATORY REHABILITATION

Disability associated with chronic obstructive pulmonary disease has l ed to the development of rehabilitation programmes that aim to increas e exercise tolerance and improve quality of life. Many reports of the benefits of rehabilitation have been from uncontrolled trials and unsu pervised programmes. In view of asked of patients, their families, pro fessionals, rehabilitation should be justified by a demonstration of s ustained improvement over conventional treatment. We undertook a prosp ective randomised controlled trial of respiratory rehabilitation in 89 subjects (44 men, 45 women) aged 66 (SD 7) years with severe but stab le chronic obstructive pulmonary disease who received rehabilitation o r conventional community care. The treatment group were rehabilitated as inpatients for 8 weeks and supervised as outpatients for 16 weeks. Primary outcome measures of exercise tolerance and quality of life wer e made at baseline and repeated at 12, 18, and 24 weeks. The differenc e between baseline and last follow-up was significant for 6 min walk d istance (37.9 m [95% CI 10.8-65.0], p=0.0067) and submaximal cycle tim e (4.7 min [2.1-7.3]), There were also significant differences in ques tionnaire (p=0.0061), emotional function (p=0.0150), mastery (p=0.0002 ), and dyspnoea index (p=0.0053). Improvements in exercise tolerance a nd quality of life can be achieved and sustained for 6 months in patie nts undergoing respiratory rehabilitation compared with those receivin g conventional care.