Use of a Home-Based Manual as Part of a Pulmonary Rehabilitation Program

Pulmonary rehabilitation programs improve exercise capacity and quality of life in patients with COPD. Domiciliary strategies to maintain these benefits have been proposed.

This study aimed to determine whether a rehabilitation manual would facilitate the maintenance of the benefits acquired during out-patient pulmonary rehabilitation.

Fifty subjects with stable COPD were included (26 women and 24 men). All the subjects were evaluated during screening and after 12 wk of out-patient rehabilitation, and then were randomly divided into 2 groups, with one group that received the rehabilitation manual for home use (manual group) and the other group only received verbal recommendations (control group). At this point, the 2 groups were similar. After 12 wk at home, both groups were evaluated a third time. All evaluations included a 6-min walk test (6MWT), 6-min step test, COPD Assessment Test, and measurement of dyspnea by using the modified Medical Research Council dyspnea scale.

When comparing the results of the 6MWT and 6-min step test done at out-patient discharge and after 12 wk at home, the manual group presented no differences (6MWT, 0 ± 25 m; 6-min step test, 1 ± 32 steps), whereas the control subjects lost part of the gain obtained during rehabilitation (6MWT -46 ± 36 m; 6-min step test -39 ± 33 steps). There was a significant difference between the groups (P < .05). When comparing the same time points, the change in the COPD Assessment Test score was -1 ± 1 for the manual group and 1 ± 2 for the control group (P = .01). For the modified Medical Research Council dyspnea scale, the change in score was 0 ± 1 for the manual group and 1 ± 1 for the control group (P = .01).

The use of a simple, well-illustrated manual facilitated the maintenance of the benefits acquired in out-patient pulmonary rehabilitation over a period of 3 months after study termination.