Pulmonary rehabilitation in outpatients with asthma or chronic obstructivelung disease - A pilot study of a "modular" rehabilitation programme

Study/Principles: Pulmonary rehabilitation programmes are often costly and dependent on the infrastructure of specialised centres. We developed a modu lar, outpatient-based rehabilitation programme, which is inexpensive and ca n be implemented in a variety of settings. The aim of this study was to det ermine the effects and feasibility of this programme. Methods: Thirteen patients with COPD and 7 patients with asthma were enroll ed by their primary care physician because of dyspnoea. Initial assessment included cardiopulmonary exercise testing, six-minute walking distance, lun g function testing and multiple questionnaires addressing dyspnoea, depress ion and quality of life issues. The training consisted of 36 sessions of hi gh intensity training of 2 hours duration to improve exercise tolerance, in cluding 30 minutes of stationary cycling at the anaerobic threshold. Anothe r complete assessment was done on completion of the study at 3 months. Results. The six-minute walking distance improved significantly from 401 to 551 m (p <0.0001). The maximal exercise capacity increased significantly f rom 85 W to 99 W (p <0.001). The anaerobic threshold remained unchanged des pite the high intensity training. There was a reduction of dyspnoea and an improvement of quality of life. Conclusion: This study shows that our outpatient rehabilitation programme l eads to a benefit in exercise tolerance and health related quality of life comparable to other programmes published in the literature. The rehabilitat ion programme was very well accepted among patients, primary care physician s and health insurers.