Long-term effects of outpatient rehabilitation of COPD: A randomized trial

Chest. 2000 Apr;117(4):976-83. doi: 10.1378/chest.117.4.976.


Objective: To examine the short- and long-term effects of an outpatient pulmonary rehabilitation program for COPD patients on dyspnea, exercise, health-related quality of life, and hospitalization rate.

Setting: Secondary-care respiratory clinic in Barcelona.

Methods: We conducted a randomized controlled trial with blinding of outcome assessment and follow-up at 3, 6, 9, 12, 18, and 24 months. Sixty patients with moderate to severe COPD (age 65 +/- 7 years; FEV(1) 35 +/- 14%) were recruited. Thirty patients randomized to rehabilitation received 3 months of outpatient breathing retraining and chest physiotherapy, 3 months of daily supervised exercise, and 6 months of weekly supervised breathing exercises. Thirty patients randomized to the control group received standard care.

Results: We found significant differences between groups in perception of dyspnea (p < 0.0001), in 6-min walking test distance (p < 0.0001), and in day-to-day dyspnea, fatigue, and emotional function measured by the Chronic Respiratory Questionnaire (p < 0. 01). The improvements were evident at the third month and continued with somewhat diminished magnitude in the second year of follow-up. The PR group experienced a significant (p < 0.0001) reduction in exacerbations, but not the number of hospitalizations. The number of patients needed to treat to achieve significant benefit in health-related quality of life for a 2-year period was approximately three.

Conclusion: Outpatient rehabilitation programs can achieve worthwhile benefits that persist for a period of 2 years.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Ambulatory Care*
  • Breathing Exercises*
  • Dyspnea / etiology
  • Dyspnea / psychology
  • Dyspnea / rehabilitation
  • Follow-Up Studies
  • Hospitalization / statistics & numerical data
  • Humans
  • Lung Diseases, Obstructive / complications
  • Lung Diseases, Obstructive / psychology
  • Lung Diseases, Obstructive / rehabilitation*
  • Male
  • Middle Aged
  • Oxygen Inhalation Therapy*
  • Prospective Studies
  • Quality of Life
  • Respiratory Function Tests
  • Surveys and Questionnaires
  • Treatment Outcome