A comparative study of the effectiveness of hospital-based versus home-based pulmonary rehabilitation in candidates for bronchoscopic lung volume reduction.
Bronchoscopic lung volume reduction
Emphysema
Exercise capacity
Pulmonary rehabilitation
Journal
Heart & lung : the journal of critical care
ISSN: 1527-3288
Titre abrégé: Heart Lung
Pays: United States
ID NLM: 0330057
Informations de publication
Date de publication:
Historique:
received:
21
03
2020
revised:
22
05
2020
accepted:
22
06
2020
pubmed:
28
7
2020
medline:
5
3
2021
entrez:
26
7
2020
Statut:
ppublish
Résumé
The Bronchoscopic Lung Volume Reduction (BLVR) is recommended in patients with severe Chronic Obstructive Pulmonary Disease (COPD) who are still symptomatic and have hyperinflation despite having received optimal medical therapy and Pulmonary Rehabilitation (PR). However, the small number of PR centers is insufficient to compensate for the need for existing hospital-based PR programs. This article aimed to compare between hospital-based and home-based PR programs in terms of effectiveness on BLVR candidates. This study is a prospective, controlled, nonrandomized clinical trial. Stable COPD patients who were referred to our PR clinic prior to BLVR were recruited consecutively. Patients were evaluated in two groups, hospital-based PR (Group 1) or home-based PR (Group 2). Both groups were admitted to the recommended PR for eight weeks. Pulmonary function tests, modified Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT) and the 6-min walk distance (6MWD) were assessed for each patient before and after PR. A total of 67 patients were enrolled in the study. The max. age was 79 years and min. age was 49 years, with 65(±7.45) as a mean ±SD. Improvements in the mMRC and CAT scores after PR in both groups were significant and a similar level. Whereas, 6MWD was only significantly increased in Group 1. This study, demonstrated that both home-based and hospital-based PR provided significant and similar improvements in the mMRC and CAT scores but 6MWD was only significantly increased in the hospital-based PR. Since 6MWD after PR plays a major role in BLVR eligibility, our findings suggest that hospital-based PR may be the most appropriate method for BLVR candidates.
Sections du résumé
BACKGROUND
The Bronchoscopic Lung Volume Reduction (BLVR) is recommended in patients with severe Chronic Obstructive Pulmonary Disease (COPD) who are still symptomatic and have hyperinflation despite having received optimal medical therapy and Pulmonary Rehabilitation (PR). However, the small number of PR centers is insufficient to compensate for the need for existing hospital-based PR programs.
OBJECTIVE
This article aimed to compare between hospital-based and home-based PR programs in terms of effectiveness on BLVR candidates.
METHODS
This study is a prospective, controlled, nonrandomized clinical trial. Stable COPD patients who were referred to our PR clinic prior to BLVR were recruited consecutively. Patients were evaluated in two groups, hospital-based PR (Group 1) or home-based PR (Group 2). Both groups were admitted to the recommended PR for eight weeks. Pulmonary function tests, modified Medical Research Council (mMRC) dyspnea scale, COPD Assessment Test (CAT) and the 6-min walk distance (6MWD) were assessed for each patient before and after PR.
RESULTS
A total of 67 patients were enrolled in the study. The max. age was 79 years and min. age was 49 years, with 65(±7.45) as a mean ±SD. Improvements in the mMRC and CAT scores after PR in both groups were significant and a similar level. Whereas, 6MWD was only significantly increased in Group 1.
CONCLUSIONS
This study, demonstrated that both home-based and hospital-based PR provided significant and similar improvements in the mMRC and CAT scores but 6MWD was only significantly increased in the hospital-based PR. Since 6MWD after PR plays a major role in BLVR eligibility, our findings suggest that hospital-based PR may be the most appropriate method for BLVR candidates.
Identifiants
pubmed: 32709500
pii: S0147-9563(20)30271-5
doi: 10.1016/j.hrtlng.2020.06.011
pii:
doi:
Banques de données
ClinicalTrials.gov
['NCT03518177']
Types de publication
Controlled Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
959-964Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The author(s) declared no potential conflict of interest with respect to the research, authorship, and/or publication of the article. The authors declare that they have no conflict of interest