Home-based pulmonary rehabilitation program: effect on exercise tolerance and quality of life in chronic obstructive pulmonary disease patients

ABSTRACT

A key component in the management of chronic obstructive pulmonary disease [COPD] patients is pulmonary rehabilitation [PR], the corner stone of which is exercise training. This study aims to evaluate the effect of a two-months, home-based PR program with outpatient supervision every two weeks, on exercise tolerance and health-related quality of life [HRQL] using Arabic-translated standardized generic and specific questionnaires in COPD patients recently recovered from acute exacerbation. Randomized clinical trial. A total of 39 COPD patients who recovered from acute exacerbation were randomly allocated either a two-month home-based PR program in addition to standard medical therapy or standard medical therapy alone in the period between July 2008 and March 2009. Pulmonary function tests [PFTs], six-minute walk distance [6-MWD] test, Arabic-translated chronic respiratory disease questionnaire-self administered standardized format [CRQ-SAS] and quality of life scale Short Form [SF-36] were compared between 25 patients with moderate to severe COPD who underwent a two-month PR program [group 1] and 14 COPD patients who did not [group 2]. Group 1 showed significant improvement in the 6-MWD, and HRQL scores at two months compared with the usual care patients in group 2 [P less than 0.05]. Improvement in both CRQ-SAS and SF036 scores were statistically significant and comparable in group 1. The supervisited, post discharge, two-month home-based PR program is an effective non pharmacological intervention in the management of stable patients with COPD. The 6-MWD is a simple, inexpensive and safe test to assess physical and functional capabilities among COPD patients. HRQL can be measured in patients with COPD either by disease-specific tools that have been specifically designed for use in patients with respiratory system disorders or by generic HRQL tools that can be used across populations with a variety of medical conditions. The Arabic-translated CRQ-SAS is a new tool for assessment of Arabic-speaking patients with chronic respiratory diseases