Benefits of Long-Term Pulmonary Rehabilitation Maintenance Program in Patients with Severe Chronic Obstructive Pulmonary Disease. Three-Year Follow-up

In chronic obstructive pulmonary disease (COPD), the benefits of pulmonary rehabilitation (PR) tend to wane over time. Whether maintenance techniques may help sustain the benefits achieved after completion of the initial PR program remains controversial. To determine whether a long-term (3-yr) maint...

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Bibliographic Details
Published in:American journal of respiratory and critical care medicine 2017-03, Vol.195 (5), p.622-629
Main Authors: Güell, Maria-Rosa, Cejudo, Pilar, Ortega, Francisco, Puy, M Carmen, Rodríguez-Trigo, Gema, Pijoan, José Ignacio, Martinez-Indart, Lorea, Gorostiza, Amaia, Bdeir, Khaled, Celli, Bartolome, Galdiz, Juan B
Format: Article
Language:English
Subjects:
Exercise Test - statistics & numerical data
Female
Follow-Up Studies
Forced Expiratory Volume
Humans
Male
Middle Aged
Prospective Studies
Pulmonary Disease, Chronic Obstructive - rehabilitation
Quality of Life
Surveys and Questionnaires
Treatment Outcome
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Summary:In chronic obstructive pulmonary disease (COPD), the benefits of pulmonary rehabilitation (PR) tend to wane over time. Whether maintenance techniques may help sustain the benefits achieved after completion of the initial PR program remains controversial. To determine whether a long-term (3-yr) maintenance program after PR preserves the short-term effects on outcomes in patients with COPD. This was a multicenter prospective randomized trial including 143 patients with moderate-severe COPD, with 3 years of PR maintenance following an 8-week outpatient PR program. Patients were randomized to maintenance intervention group (IG) and standard monitoring program or control group (CG). The effects on BODE index, 6-minute-walk test distance (6MWD), and health-related quality of life were compared at 12, 24, and 36 months. A total of 138 (96.5%) completed the 8-week program. At this time, all outcomes (BODE, 6MWD, and health-related quality of life) showed clinically and statistically significant improvements (P ≤ 0.001). During the follow-up period, the magnitude of change in 6MWD differed between IG and CG (P = 0.042), with a slight initial increase in the IG during the first year and smaller decline afterward. The BODE index changes differed between baseline and measurements at Month 24 (P = 0.043). At 3 years, the adherence rate of IG patients was 66% and 17% for the CG group (P 
ISSN:1073-449X
1535-4970
DOI:10.1164/rccm.201603-0602OC