Pulmonary Rehabilitation at Home Versus at the Gymnasium

Laval University

Status: Completed

Conditions: COPD

Treatments: Behavioral: Pulmonary rehabilitation (teaching and exercise)

Study type: Interventional

Funder types: Other

Identifiers

NCT00169897

ISRCTN32824512

Details and patient eligibility

About

Short term efficacy of pulmonary rehabilitation for improving functional capacity and quality of life of chronic obstructive respiratory disease (COPD) patient is well known. However, there is an important gap between the scientific knowledge and the clinical use of pulmonary rehabilitation since a a very small number of patients benefit from this therapeutic intervention. We estimate that less than 1% of the 750 000 canadians suffering from COPD have access to a pulmonary rehabilitation program. We want to study the efficacy of a home-based rehabilitation program as a way to facilitate the access to rehabilitation.

Full description

This article on the main outcome is available. Maltais F, Bourbeau J, Shapiro S, Lacasse Y, Perrault H, Baltzan M, Hernandez P, Rouleau M, Julien M, Parenteau S, Paradis B, Levy RD, Camp P, Lecours R, Audet R, Hutton B, Penrod JR, Picard D, Bernard S. Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Ann Int Med 2008;149:869-878.

Enrollment: 252 patients

Sex: All

Ages: 40 to 95 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Subject is able to ambulate. Defined as a 6MWD greater than 110 meters.
• Subject is diagnosed with COPD.
• 40 years-old and older
• Currently or previously smoking with a smoking history of at least 10 pack-years.
• Forced expiratory volume on one second (FEV1) after the use of a bronchodilator between 25 an 70% of the predicted value, and FEV1 to forced vital capacity ratio less than 70%.
• No previous diagnosis of asthma, left heart congestive heart failure (either radiographic evidence of pulmonary congestion, echocardiographic or ventriculographic evidence of a reduced ventricular ejection fraction), terminal disease, dementia or uncontrolled psychiatric illness.
• Never participated to a respiratory rehabilitation program and not staying or planning to stay in a long term care facility.
• Subject understands and is able to read and write French or English.
• MRC dyspnea scale of at least 2.

Exclusion criteria

• The need for supplemental oxygen at rest or during exercise will not be an exclusion criterion.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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252 participants in 2 patient groups

Hospital-based

Experimental group

Description:

This group has to go at the hospital 3 times per week to do the exercise program.

Treatment:

Behavioral: Pulmonary rehabilitation (teaching and exercise)

Home-Based

Active Comparator group

Description:

The group had to do the exercise program at home with indirect supervision (Polar watches and a phone call per week).

Treatment:

Behavioral: Pulmonary rehabilitation (teaching and exercise)