Maintenance after pulmonary rehabilitation in chronic lung disease: a randomized trial

Am J Respir Crit Care Med. 2003 Mar 15;167(6):880-8. doi: 10.1164/rccm.200204-318OC. Epub 2002 Dec 27.


Pulmonary rehabilitation is beneficial for patients with chronic lung disease. However, long-term maintenance has been difficult to achieve after short-term treatment. We evaluated a telephone-based maintenance program after pulmonary rehabilitation in 172 patients with chronic lung disease recruited from pulmonary rehabilitation graduates. Subjects were randomly assigned to a 12-month maintenance intervention with weekly telephone contacts and monthly supervised reinforcement sessions (n = 87) or standard care (n = 85) and followed for 24 months. Except for a slight imbalance between sexes, experimental and control groups were equivalent at baseline and showed similar improvements after rehabilitation. During the 12-month intervention, exercise tolerance (maximum treadmill workload and 6-minute walk distance) and overall health status ratings were better maintained in the experimental group together with a reduction in hospital days. There were no group differences for other measures of pulmonary function, dyspnea, self-efficacy, generic and disease-specific quality of life, and health care use. By 24 months, there were no significant group differences. Patients returned to levels close to but above prerehabilitation measures. We conclude that a maintenance program of weekly telephone calls and monthly supervised sessions produced only modest improvements in the maintenance of benefits after pulmonary rehabilitation.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aftercare / methods*
  • Aged
  • Attitude to Health
  • Dyspnea / etiology
  • Exercise Test
  • Exercise Therapy / methods*
  • Exercise Tolerance
  • Female
  • Follow-Up Studies
  • Forced Expiratory Volume
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Patient Compliance / psychology*
  • Patient Education as Topic / methods*
  • Patient Readmission / statistics & numerical data
  • Program Evaluation
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / psychology*
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Quality of Life
  • Reinforcement, Psychology*
  • Respiratory Function Tests
  • Self Efficacy
  • Surveys and Questionnaires
  • Telephone*