Home-based exercise training as maintenance after outpatient pulmonary rehabilitation

Pulmonary rehabilitation is successful in improving exercise capacity and quality of life in patients with chronic obstructive pulmonary disease (COPD). However, training effects diminish over time.

We evaluated the effects of simple, daily, structured, self-monitored, home-based exercise training for patients with moderate COPD after a 3-week outpatient rehabilitation.

We conducted a randomized, controlled, observer-blind trial. Twenty patients were recruited. Ten patients performed home-based exercise training (mean age 67 years, 95% confidence interval [CI] 63-72; FEV(1) 58.6%, 95% CI 53.8-63.4), and 10 patients served as controls (mean age 72 years, 95% CI 69-77; FEV(1) 62.5%, 95% CI 57.7-67.3). At baseline, and after 3 and 6 months, we assessed exercise capacity (6-min walk test, 6MWT, primary endpoint), health-related quality of life (Chronic Respiratory Questionnaire, CRQ) and lung function. An intention-to-treat analysis was performed using two-way ANOVA models for comparison of time trends between random groups.

The training group had better results than the control group in 6MWT (p = 0.033), in CRQ total (p = 0.027), CRQ dyspnea (p = 0.014) and CRQ fatigue (p = 0.016). Improvement in FEV(1) was also better in the intervention group than in the control group (p = 0.007).

We demonstrated that training effects obtained from an outpatient rehabilitation program can be maintained by home-based exercise training in patients with moderate COPD.