Long-term effects of home rehabilitation on physical performance in chronic obstructive pulmonary disease

A pilot study was set up to assess the long-term effects of once weekly versus once monthly follow-up of pulmonary rehabilitation after a comprehensive home rehabilitation program on physical performance in patients with chronic obstructive pulmonary disease (COPD) during an 18-mo period. Thirty-six patients with a mean FEV(1) of 1.3 +/- 0.4 L (43% pred) were included in the study. Groups A and B (n = 23) visited the physical therapist twice weekly for 3 mo. Thereafter, 11 patients (Group A) had a follow-up of pulmonary rehabilitation once a week, and 12 patients (Group B) had a follow-up once a month. Thirteen patients received no rehabilitation at all (Group C). Long-term home rehabilitation does not appear to improve exercise tolerance; however, on the other hand, there is a deterioration in vital capacity (p <0.01), walking distance (p <0.01), and maximal work load (p <0.05), as shown in the control group. A small improvement in exertional dyspnea (p <0.01) after 18 mo and inspiratory muscle function (p <0.05) after 12 mo was shown only in Group A. Because of the insufficient number of patients enrolled in this pilot study, no clear benefit on physical performance of long-term home rehabilitation with either weekly or monthly supervision could be demonstrated.