Efficacy of pulmonary rehabilitation in patients with moderate chronic obstructive pulmonary disease: a randomized controlled trial

• Main Authors: Román Miguel, Larraz Concepción, Gómez Amalia, Ripoll Joana, Mir Isabel, Miranda Eduardo Z, Macho Ana, Thomas Vicenç, Esteva Magdalena
• Format: Article
• Language: English
• Published: BMC 2013-02-01
• Series: BMC Family Practice
• Subjects: Chronic obstructive pulmonary disease; Pulmonary rehabilitation; Quality of life; Clinical trial; Primary care
• Online Access: http://www.biomedcentral.com/1471-2296/14/21

<p>Abstract</p> <p>Background</p> <p>Pulmonary Rehabilitation for moderate Chronic Obstructive Pulmonary Disease in primary care could improve patients’ quality of life.</p> <p>Methods</p> <p>This study aimed to assess the efficacy of a 3-month Pulmonary Rehabilitation (PR) program with a further 9 months of maintenance (RHBM group) compared with both PR for 3 months without further maintenance (RHB group) and usual care in improving the quality of life of patients with moderate COPD.</p> <p>We conducted a parallel-group, randomized clinical trial in Majorca primary health care in which 97 patients with moderate COPD were assigned to the 3 groups. Health outcomes were quality of life, exercise capacity, pulmonary function and exacerbations.</p> <p>Results</p> <p>We found statistically and clinically significant differences in the three groups at 3 months in the emotion dimension (0.53; 95%CI0.06-1.01) in the usual care group, (0.72; 95%CI0.26-1.18) the RHB group (0.87; 95%CI 0.44-1.30) and the RHBM group as well as in fatigue (0.47; 95%CI 0.17-0.78) in the RHBM group. After 1 year, these differences favored the long-term rehabilitation group in the domains of fatigue (0.56; 95%CI 0.22-0.91), mastery (0.79; 95%CI 0.03-1.55) and emotion (0.75; 95%CI 0.17-1.33). Between-group analysis only showed statistically and clinically significant differences between the RHB group and control group in the dyspnea dimension (0.79 95%CI 0.05-1.52). No differences were found for exacerbations, pulmonary function or exercise capacity.</p> <p>Conclusions</p> <p>We found that patients with moderate COPD and low level of impairment did not show meaningful changes in QoL, exercise tolerance, pulmonary function or exacerbation after a one-year, community based rehabilitation program. However, long-term improvements in the emotional, fatigue and mastery dimensions (within intervention groups) were identified.</p> <p>Trial registration</p> <p>ISRCTN94514482</p>