Implementation of a 'Can do-Do do'-guided pulmonary rehabilitation programme: a retrospective single-centre cohort...

Improving immediate and long-term outcomes of Pulmonary Rehabilitation (PR) remains challenging. The "Can do-Do do" concept distinguishes physical capacity (what a patient is able to do) from physical activity (what a patient actually does), stratifying patients into four quadrants. This study evaluated immediate and one-year multidimensional health outcomes of a "Can do-Do do"-guided PR program.

This retrospective study included 934 patients with Chronic Respiratory Diseases (CRD) participating in a 10-week "Can do-Do do"-guided PR program. At baseline, patients were classified into four quadrants based on peak oxygen uptake (VO_2,peak) and daily steps and multidisciplinary team consensus: "Can do-Do do", "Can do-Don't do", "Can't do-Do do", and "Can't do-Don't do". PR interventions were tailored to each quadrant. Multidimensional health outcomes were assessed at the end of PR and at one-year follow-up using generalized linear models.

Patients were allocated to the four quadrants in 12,5%, 17,1%, 20,0%, and 49,4%, respectively. Substantial baseline differences existed between quadrants in CRD type, lung function, muscle strength, VO_2,peak, and daily steps, whereas quality of life and psychosocial well-being were similarly impaired. At end-of-PR, all quadrants showed significant improvements in physical capacity, symptoms, functional impairment, and quality of life. At one year, most improvements remained significant, although attenuated, with small to large effect sizes.

The "Can do-Do do" concept identifies four distinct CRD patient groups with different PR needs. Tailoring PR to these groups may offer a novel approach to improving multidimensional health outcomes.