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Short‐ and long‐term hospital and community exercise programmes for patients with chronic obstructive pulmonary disease
Author(s) -
ELLIOTT Mercedes,
WATSON Carol,
WILKINSON Eve,
MUSK Arthur W.,
LAKE Fiona R.
Publication year - 2004
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2004.00595.x
Subject(s) - medicine , copd , physical therapy , community hospital , quality of life (healthcare) , pulmonary disease , rehabilitation , wilcoxon signed rank test , pulmonary rehabilitation , pulmonary function testing , randomized controlled trial , nursing , mann–whitney u test
Objective: Pulmonary rehabilitation in patients with COPD has been shown to be beneficial but the optimal setting is not known. In the present study, the efficacy of a short‐term community‐based exercise programme was compared with a standard hospital outpatient programme. Additionally, the usefulness of community or home programmes in maintaining improvements in the longer term was studied. Methodology: Forty‐three patients with moderate to severe COPD were randomized to one of the following three groups: a 3‐month hospital programme then a 9 month home programme (Hospital/Home); a 3‐month hospital programme then a 9‐month community programme (Hospital/Community); or a 12‐month community programme (Community/Community). The initial 3‐month programme was analysed by comparing the Hospital group (Hospital/Home plus Hospital/Community) with the Community group (Community/Community). Six‐minute walking distance (6MWD), quality of life (Guyatt chronic respiratory disease questionnaire, CRQ) and lung function were measured at 0, 3, 6 and 12 months and results were analysed using the Wilcoxon rank sum test. Results: At 3 months, there was a significant improvement from baseline in 6MWD in the Hospital group (81.3 ± 18.3 m, P < 0.05, anova ) but not the Community group (14.4 ± 28.5 m, not significant). The difference between the groups was not significant ( P = 0.058). At 3 months, there was a significant improvement in quality of life in the Hospital group (CRQ +16.3 ± 3.1, P < 0.01, anova ) and in the Community group (CRQ +10.2 ± 4.9, P < 0.05, anova ) but the difference between the groups was not significant. Following the initial 3‐month programme, the dropout rate was high overall (73% by 12 months), and therefore data from the maintenance programme could not be analysed. Conclusions: A 3‐month community‐based exercise programme for patients with COPD did not improve 6MWD. The long‐term retention rates in the programmes were poor.