The effects of a 12-week home care rehabilitation programme (HCRP) and a 12-week hospital rehabilitation programme (HRP) are described in 30 patients with severe COPD. A control group (n = 15) received no rehabilitation programme. Results were assessed in a follow-up of 18 months. After HCRP, an ongoing improvement in exercise capacity (4 minute-walking test and cycle ergometer test) was observed up to the last visit. Borg dyspnea scores at equal work levels during exercise also remained significantly improved. After HRP exercise capacity and Dyspnea scores were significantly improved up to 6 months after the start of the study. In both rehabilitation groups 'Leg Effort' scores at equal work levels, were only improved initially. In 64% a significant improvement in well-being was measured until 18 months after the start of the study. After rehabilitation, no physiological changes (SaO2 and Heart Frequency) during exercise were detected. This indicated that desensitisation to dyspnea probably contributes towards the improved exercise tolerance in these patients. It is concluded that both HCRP and HRP show beneficial effects in patients with sever COPD. The results indicate that the benefits were of longer duration after an HCRP. This is probably due to the fact that after an HCRP patients have become accustomed to exercising more frequently at home. HCRP is therefore a worthwhile option in the treatment of COPD patients.

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