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

BMC Family Practice

Research Article

Ana Macho¹  Amalia Gómez²  Concepción Larraz³  Isabel Mir⁴  Miguel Román⁵  Joana Ripoll⁶  Magdalena Esteva⁶  Vicenç Thomas⁷  Eduardo Z Miranda⁸ 

[1] Primary Care Madrid Department, Aspes Primary Health Centre, Madrid, Spain;Primary Care Majorca Department, Coll d´en Rabassa Primary Health Centre, Palma de MallorcaBaleares, Spain;Primary Care Majorca Department, Escuela Graduada Primary Health Centre, Palma de MallorcaBaleares, Spain;Primary Care Majorca Department, Hospital Son Llàtzer, Unit of Pneumology, Palma de Mallorca, Baleares, Spain;Primary Care Majorca Department, Son Pisà Primary Health Centre, C/ Vicenç Joan Perello Ribes, 65, Palma de Mallorca, Baleares, Spain;Primary Care Majorca Department, Unit of Research, Palma de Mallorca, Baleares, Spain;Primary Care Majorca, Camp Redó Primary Health Centre, Palma de Mallorca, Baleares, Spain;Primary Care Majorca, Emili Darder Primary Health Centre, Palma de Mallorca, Baleares, Spain;

关键词: Chronic obstructive pulmonary disease;    Pulmonary rehabilitation;    Quality of life;    Clinical trial;    Primary care;   

DOI  :  10.1186/1471-2296-14-21

 received in 2012-11-05, accepted in 2013-02-02,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundPulmonary Rehabilitation for moderate Chronic Obstructive Pulmonary Disease in primary care could improve patients’ quality of life.MethodsThis 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.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.ResultsWe 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.ConclusionsWe 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.Trial registrationISRCTN94514482

【 授权许可】

Unknown   
© Roman et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.