Minimal versus specialist equipment for the delivery of pulmonary rehabilitation in COPD

Abstract

Background: Evidence for pulmonary rehabilitation(PR)largely comes from trials where the intervention used specialist aerobic and/or resistance equipment.Limited data exist to demonstrate the efficacy of PR in community settings with minimal equipment. Aims: To compare completion rates and outcomes in COPD patients undergoing PR in a community setting with minimal equipment(PR-min)with a matched sample undergoing PR in a gym setting with specialist aerobic and resistance equipment(PR-gym). Methods: Using propensity score matching,318 patients with COPD referred for 8 weeks of PR-min were matched 1:1 with a control group of 318 patients who undertook 8 weeks of PR-gym. Completion rate(attendance≥8 supervised sessions)and changes in incremental shuttle walk(ISW),Chronic Respiratory Disease Questionnaire(CRQ)and quadriceps maximal voluntary contraction(QMVC)were compared. Results: Groups were matched for age(70.8v70.7years),FEV1%predicted(46.8v45.8),ISW(192v195m),%current smoking status(19v20)and depression scores(6.5v6.6).No between group differences were seen in ISW,CRQ or QMVC change. Completion rates were better in the PR-gym(73%)as opposed to the PR-min(64%);p=0.01. Conclusion: This case-control study shows that PR-min had similar benefits to PR-gym.A randomised non-inferiority trial is needed to confirm the findings of this study

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