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The effectiveness of outpatient pulmonary rehabilitation in chronic lung disease: a randomized controlled trial |
Finnerty JP, Keeping I, Bullough I, Jones J |
Chest 2001 Jun;119(6):1705-1710 |
clinical trial |
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; 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: Patients with chronic pulmonary disease have been shown to benefit from pulmonary rehabilitation programs. Published work has often been from specialized teaching centers and has involved inpatient stay. We assessed an entirely outpatient-based program of pulmonary rehabilitation in patients with chronic lung disease, using the St George's Respiratory Questionnaire (SGRQ) (which measures health-related quality of life) as the primary outcome measure. METHODS: We undertook a randomized, prospective, parallel-group controlled study of an outpatient rehabilitation program in 65 patients with COPD (44 men and 21 women; mean age 69.5 years (SD 9.2 years); FEV1, 41% predicted (SD 18.5%)). The active group (n = 36) took part in a 6-week program of education (2 h weekly) and exercise (1 h weekly). The control group (n = 29) were reviewed routinely as medical outpatients. The SGRQ was administered under supervision by a blinded observer at study entry, 12 weeks, and 24 weeks. RESULTS: The SGRQ in the active group was 59.9 (SE 2.0) at study entry (n = 36), 47.4 (SE 2.3) at 12 weeks (n = 32), and 50.6 (SE 2.5) at 24 weeks (n = 24). The SGRQ in the control group was 59.3 (SE 2.5) at study entry and did not change significantly over 24 weeks. There was a difference of 10.4 points (confidence interval (CI) 3.6 to 17.3) between the two groups at 12 weeks (p < 0.001) and of 8.1 points (CI 1.4 to 14.9) at 24 weeks (p = 0.02) in favor of the active group. CONCLUSIONS: A 6-week outpatient-based program significantly improved quality of life in patients with moderate-to-severe COPD. Benefit was still evident after 24 weeks.
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