Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial

Area of Science:

• Pulmonary Medicine
• Rehabilitation Science
• Chronic Obstructive Pulmonary Disease (COPD) Management

Background:

• Pulmonary rehabilitation is crucial for COPD care, but traditional center-based programs have low participation rates.
• This study investigated a home-based pulmonary rehabilitation model as an alternative to center-based care.

Purpose of the Study:

• To assess if a minimally resourced home-based pulmonary rehabilitation program yields equivalent outcomes to traditional center-based programs.
• To compare the effectiveness of home-based versus center-based pulmonary rehabilitation in COPD patients.

Main Methods:

• A randomized controlled equivalence trial with 12-month follow-up was conducted.
• Participants with stable COPD were assigned to either an 8-week center-based program or a home-based program (one home visit, seven telephone calls).
• The primary outcome was the change in 6-minute walk distance (6MWD).

Main Results:

• Home-based rehabilitation was non-inferior to center-based rehabilitation for 6MWD at the end of the program.
• Short-term improvements in 6MWD and dyspnea-related quality of life favored the home-based group.
• Neither group maintained rehabilitation gains at the 12-month follow-up.

Conclusions:

• A minimally resourced home-based pulmonary rehabilitation model achieves short-term clinical outcomes equivalent to center-based programs.
• Neither rehabilitation model effectively sustained improvements at 12 months.
• Home-based pulmonary rehabilitation is a viable option for COPD patients unable to access center-based care.