August 22, 2022

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A 12-month, home-based exercise program improved exercise capacity and patient-perceived fitness in adults with COPD but did not affect dyspnea, according to new data published in Chest.

“Home-based programs became increasingly popular in the last years and complement traditional center-based inpatient and outpatient [pulmonary rehabilitation],” Anja Frei, PhD, of the Epidemiology, Biostatistics and Prevention Institute at the University of Zurich, and colleagues wrote. “Consequently, a rising number of randomized controlled trials have investigated the effectiveness of home-based programs, and the consideration of these alternative models and opportunities and challenges for [pulmonary rehabilitation] are currently debated.”



Key takeaways

Data were derived from Frei A, et al. Chest. 2022;doi:10.1016/j.chest.2022.07.026.

The researchers conducted a randomized, parallel-arm, multicenter study across four pulmonary rehabilitation clinics in Switzerland. The study included 123 patients with COPD (mean age, 66.8 years; 49.5% women), of whom 61 were randomly assigned to an intervention group that followed HOMEX, a home-based strength training program, and 62 to standard care.

The primary outcome was dyspnea change from baseline to 12 months, assessed via a self-administered Chronic Respiratory Questionnaire. Secondary outcomes included change in exercise capacity (measured by a 1-minute sit-to-stand test and 6-minute walk test), health-related quality of life, event-based exacerbations and COPD symptoms.

According to results, 104 of the participants completed 12-month follow-up evaluations, including 53 in the intervention group and 51 in the control group. Of those in the intervention group, 70% performed the exercises through study completion.

Researchers reported no difference in change in dyspnea between groups over the 12-month period (adjusted mean difference = 0.28; 95% CI, –0.23 to 0.80) but did report moderate differences in 1-minute sit-to-stand repetitions that favored the intervention group (adjusted mean difference = 2.6; 95% CI, 0.22-5.03). There was no evidence for effect in the remaining outcomes.

A follow-up satisfaction survey revealed that 81% of intervention participants enjoyed the program and 79% reported experiencing positive effects from the training.

“Besides assessing this intervention in a larger sample, we suggest that further research should identify characteristics of patients who are able to adhere long-term to such minimal-equipment, home-based programs and for whom other programs are more appropriate,” the researchers wrote.

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