Use the Back button in your browser to see the other results of your search or to select another record.
|Effectiveness of a long-term home-based exercise training program in patients with COPD following pulmonary rehabilitation: a multi-center randomized controlled trial [with consumer summary]|
|Frei A, Radtke T, Lana KD, Brun P, Sigrist T, Spielmanns M, Beyer S, Riegler TF, Busching G, Spielmanns S, Kunz R, Cerini T, Braun J, Tomonaga Y, Burriel MS, Polhemus A, Puhan MA|
|Chest 2022 Dec;162(6):1277-1286|
|5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*|
BACKGROUND: The majority of patients with COPD fail to maintain exercise training after pulmonary rehabilitation (PR). RESEARCH QUESTION: Does a 12-months home-based, minimal equipment strength training program following PR has an effect on dyspnea, exercise capacity, and patient-reported outcomes in patients with COPD? STUDY DESIGN AND METHODS: Parallel arm, multicenter study across four Swiss PR clinics, COPD patients were randomly allocated (1:1 ratio) into intervention group (IG, home-based strength training program) or control group (CG, usual care). Primary outcome was change in dyspnea (Chronic Respiratory Questionnaire, CRQ) from baseline to 12 months, secondary outcomes were change in exercise capacity (1-minute-sit-to-stand-test (1-min-STST), six-minute walk test (6MWT)), health-related quality of life, exacerbations, and symptoms. We assessed the IG participants' experience by interviews at study end. Main analyses were based on the intention-to-treat approach and adjusted linear regression models were used. RESULTS: 123 COPD patients (IG: 61, CG: 62) were randomized, 61 females, mean (SD) age 66.8 (8.1) years, mean FEV1 39.3 (15.3) % predicted. 104 participants completed 12-month follow-up (IG: 53, CG: 51). Out of the 53 IG participants, 37 (70%) conducted the training until study end. We found no difference in change of CRQ dyspnea over 12 months (adjusted mean difference 0.28, 95% CI -0.23 to 0.80, p = 0.27). We found moderate evidence for a difference in 1-min-STST repetitions favoring the IG (adjusted mean difference 2.6, 95% CI 0.22 to 5.03, p = 0.033), but no evidence for an effect in other outcomes. Seventy-nine percent of the IG participants reported positive effects that they attributed to the training. INTERPRETATION: The HOMEX exercise program had no effect on dyspnea but improved 1-min-STST performance and patient-perceived fitness. The supported program was well accepted by COPD patients and may facilitate continued exercise training at home.