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Benefits of a Home-Based Pulmonary Rehabilitation Program for Patients With Severe Chronic Obstructive Pulmonary Disease
Vanessa Regiane Resquetia, Amaia Gorostizab, Juan B. Gladisb, Elena López de Santa Maríab, Pere Casan Claràa, Rosa Güell Rousa,
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vanessaresqueti@hotmail.com
Correspondence: Dra. R. Güell Rous. Área de Rehabilitación-Departamento de Neumología. Hospital de la Santa Creu i de Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España
Correspondence: Dra. R. Güell Rous. Área de Rehabilitación-Departamento de Neumología. Hospital de la Santa Creu i de Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España
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"paginaFinal" => "604" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Vanessa Regiane Resqueti, Amaia Gorostiza, Juan B. Gladis, Elena López de Santa María, Pere Casan Clarà, Rosa Güell Rous" "autores" => array:6 [ 0 => array:3 [ "nombre" => "Vanessa Regiane" "apellidos" => "Resqueti" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "Amaia" "apellidos" => "Gorostiza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Juan B." "apellidos" => "Gladis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 3 => array:3 [ "nombre" => "Elena López" "apellidos" => "de Santa María" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 4 => array:3 [ "nombre" => "Pere Casan" "apellidos" => "Clarà" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 5 => array:4 [ "nombre" => "Rosa Güell" "apellidos" => "Rous" "email" => array:1 [ 0 => "vanessaresqueti@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital de la Santa Creu i de Sant Pau, Facultad de Medicina, Universidad Autónoma de Barcelona, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Hospital de Cruces, Barakaldo, Vizcaya, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra. R. Güell Rous. Área de Rehabilitación-Departamento de Neumología. Hospital de la Santa Creu i de Sant Pau. Sant Antoni M. Claret, 167. 08025 Barcelona. España" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-09-25" "fechaAceptado" => "2007-03-20" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec154658" "palabras" => array:5 [ 0 => "Chronic obstructive pulmonary disease (COPD)" 1 => "Pulmonary rehabilitation" 2 => "domiciliary" 3 => "Health-related quality of life" 4 => "Exercise tolerance" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec154659" "palabras" => array:4 [ 0 => "Enfermedad pulmonar obstructiva crónica (EPOC)" 1 => "Rehabilitación respiratoria domiciliaria" 2 => "Calidad de vida relacionada con la salud" 3 => "Capacidad del ejercicio" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetive</span><p class="elsevierStyleSimplePara elsevierViewall">The benefits of a domiciliary program of pulmonary rehabilitation for patients with severe to very severe chronic obstructive pulmonary disease (COPD) are uncertain. We aimed to assess the short- and medium-term efficacy of such a program in this clinical setting.</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p class="elsevierStyleSimplePara elsevierViewall">Patients with severe COPD (stages III-IV, classification of the Global Initiative for Chronic Obstructive Lung Disease) and incapacitating dyspnea (scores 3-5, Medical Research Council [MRC] scale) were randomized to a control or domiciliary rehabilitation group. The 9-week supervised pulmonary rehabilitation program included educational sessions, respiratory physiotherapy, and muscle training in weekly sessions in the patient's home. We assessed the following variables at baseline, 9 weeks, and 6 months: lung function, exercise tolerance (3-minute walk test), dyspnea (MRC score), and health-related quality of life with the Chronic Respiratory Questionnaire (CRQ).</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Thirty-eight patients with a mean (SD) age of 68 (6) years were enrolled. The mean MRC score was 4 (0.8) and mean forced expiratory volume in 1 second was 29% of reference. Twenty-nine patients completed the study (6 months). Distance covered on the walk test increased significantly in the rehabilitation group (<span class="elsevierStyleItalic">P</span>=.001) and the difference was maintained at 6 months. Dyspnea also improved significantly with rehabilitation (<span class="elsevierStyleItalic">P</span>≤.05), but the reduction was not evident at 6 months. Statistically significant improvements in symptoms related to 2 CRQ domains were detected between baseline and 9 weeks: dyspnea (3.1 [0.8] vs 3.6 [0.7]; <span class="elsevierStyleItalic">P</span>=.02) and fatigue (3.7 [0.8] vs 4.2 [0.9]; <span class="elsevierStyleItalic">P</span>=.002). A clinically relevant but not statistically significant change in mastery over disease was detected (from 4.3 to 4.9). All improvements were maintained at 6 months.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Home-based pulmonary rehabilitation for patients with severe to very severe COPD and severe functional incapacity leads to improvements in exercise tolerance and health-related quality of life that are maintained at 6 months.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Los beneficios de la rehabilitación respiratoria domiciliaria (RRD) en pacientes con enfermedad pulmonar obstructiva crónica (EPOC) de grado grave-muy grave son controvertidos. Nuestro objetivo ha sido evaluar la eficacia a corto y medio plazo de un programa de RRD en pacientes con EPOC grave.</p> <span class="elsevierStyleSectionTitle">Pacientes y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se trata de un estudio prospectivo y aleatorizado en pacientes con EPOC grave (estadios III y IV de la clasificación GOLD) y disnea invalidante —; puntuación de 3 a 5 en la escala del Medical Research Council (MRC)—, distribuidos en grupo control y grupo RRD. El programa de rehabilitación respiratoria fue de 9 semanas y consistía en educación, fisioterapia respiratoria y entrenamiento muscular con supervisión semanal en domicilio. Evaluamos en situación basal, a las 9 semanas y a los 6 meses la función pulmonar, la capacidad de ejercicio (prueba de la marcha de 3 min), la disnea (MRC) y la calidad de vida relacionada con la salud, determinada con el Chronic Respiratory Questionnaire (CRQ).</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Participaron en el estudio 38 pacientes, con una edad media ± desviación estándar de 68 ± 6 años (puntuación MRC: 4 ± 0,8; volumen espiratorio forzado en el primer segundo: 29% del valor de referencia), y 29 completaron el seguimiento a los 6 meses. En el grupo RRD se incrementó significativamente la distancia recorrida en la prueba de la marcha de 3 min (p = 0,001), resultado que se mantuvo a los 6 meses. La disnea mejoró significativamente tras la RRD (p ≤ 0,05), pero dicha mejoría desapareció a los 6 meses. Se observó una mejoría clínica y estadísticamente significativa en 2 dominios del CRQ, el de disnea (3,1 ± 0,8 frente a 3,6 ± 0,7; p = 0,02) y el de fatiga (3,7 ± 0,8 frente a 4,2 ± 0,9; p = 0,002), y tan sólo clínica (4,3 frente a 4,9) en el control de la enfermedad, mejorías que se mantuvieron a los 6 meses.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La RRD en pacientes con EPOC grave-muy grave y alta incapacidad funcional aporta beneficios en la calidad de vida relacionada con la salud y la capacidad de ejercicio, que pueden mantenerse hasta los 6 meses.</p>" ] ] "NotaPie" => array:2 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">The preliminary results of this study were first presented at the annual European Respiratory Society Congress, September 2005 in Copenhagen, Denmark.</p>" ] 1 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">The study was partially funded by the Breathe Network (Red Respira) of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR).</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:29 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "BR Celli" 1 => "W MacNee" 2 => "ATS/ERS Task Force" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Respir J" "fecha" => "2004" "volumen" => "23" "paginaInicial" => "932" "paginaFinal" => "946" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15219010" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 4 | 6 |
| 2024 October | 27 | 21 | 48 |
| 2024 September | 22 | 24 | 46 |
| 2024 August | 45 | 30 | 75 |
| 2024 July | 23 | 22 | 45 |
| 2024 June | 34 | 23 | 57 |
| 2024 May | 52 | 29 | 81 |
| 2024 April | 41 | 26 | 67 |
| 2024 March | 32 | 11 | 43 |
| 2024 February | 15 | 19 | 34 |
| 2023 March | 3 | 2 | 5 |
| 2023 February | 15 | 20 | 35 |
| 2023 January | 17 | 15 | 32 |
| 2022 December | 21 | 25 | 46 |
| 2022 November | 16 | 21 | 37 |
| 2022 October | 28 | 26 | 54 |
| 2022 September | 16 | 18 | 34 |
| 2022 August | 14 | 30 | 44 |
| 2022 July | 17 | 32 | 49 |
| 2022 June | 13 | 28 | 41 |
| 2022 May | 17 | 21 | 38 |
| 2022 April | 17 | 28 | 45 |
| 2022 March | 15 | 34 | 49 |
| 2022 February | 15 | 26 | 41 |
| 2022 January | 12 | 27 | 39 |
| 2021 December | 13 | 48 | 61 |
| 2021 November | 22 | 42 | 64 |
| 2021 October | 28 | 42 | 70 |
| 2021 September | 15 | 63 | 78 |
| 2021 August | 13 | 23 | 36 |
| 2021 July | 10 | 27 | 37 |
| 2021 June | 12 | 32 | 44 |
| 2021 May | 15 | 21 | 36 |
| 2021 April | 21 | 47 | 68 |
| 2021 March | 16 | 24 | 40 |
| 2021 February | 12 | 12 | 24 |
| 2021 January | 10 | 18 | 28 |
| 2020 December | 10 | 10 | 20 |
| 2020 November | 4 | 19 | 23 |
| 2020 October | 15 | 14 | 29 |
| 2020 September | 2 | 5 | 7 |
| 2020 August | 10 | 13 | 23 |
| 2020 July | 12 | 10 | 22 |
| 2020 June | 4 | 10 | 14 |
| 2020 May | 14 | 16 | 30 |
| 2020 April | 5 | 16 | 21 |
| 2020 March | 10 | 21 | 31 |
| 2020 February | 11 | 19 | 30 |
| 2020 January | 14 | 21 | 35 |
| 2019 December | 12 | 13 | 25 |
| 2019 November | 8 | 13 | 21 |
| 2019 October | 7 | 7 | 14 |
| 2019 September | 8 | 20 | 28 |
| 2019 August | 12 | 6 | 18 |
| 2019 July | 15 | 22 | 37 |
| 2019 June | 11 | 21 | 32 |
| 2019 May | 20 | 14 | 34 |
| 2019 April | 12 | 35 | 47 |
| 2019 March | 14 | 20 | 34 |
| 2019 February | 9 | 15 | 24 |
| 2019 January | 12 | 9 | 21 |
| 2018 December | 13 | 13 | 26 |
| 2018 November | 19 | 17 | 36 |
| 2018 October | 24 | 12 | 36 |
| 2018 September | 13 | 14 | 27 |
| 2018 May | 2 | 0 | 2 |
| 2018 April | 9 | 3 | 12 |
| 2018 March | 7 | 4 | 11 |
| 2018 February | 5 | 8 | 13 |
| 2018 January | 2 | 5 | 7 |
| 2017 December | 5 | 6 | 11 |
| 2017 November | 5 | 4 | 9 |
| 2017 October | 9 | 6 | 15 |
| 2017 September | 4 | 4 | 8 |
| 2017 August | 7 | 21 | 28 |
| 2017 July | 5 | 6 | 11 |
| 2017 June | 8 | 11 | 19 |
| 2017 May | 8 | 9 | 17 |
| 2017 April | 5 | 5 | 10 |
| 2017 March | 4 | 8 | 12 |
| 2017 February | 5 | 7 | 12 |
| 2017 January | 2 | 2 | 4 |
| 2016 December | 9 | 7 | 16 |
| 2016 November | 13 | 7 | 20 |
| 2016 October | 18 | 11 | 29 |
| 2016 September | 10 | 11 | 21 |
| 2016 August | 6 | 4 | 10 |
| 2016 July | 3 | 4 | 7 |
| 2016 March | 3 | 0 | 3 |
| 2016 February | 1 | 0 | 1 |
| 2015 December | 2 | 0 | 2 |
| 2015 October | 36 | 24 | 60 |
| 2015 September | 41 | 17 | 58 |
| 2015 August | 20 | 11 | 31 |
| 2015 July | 28 | 15 | 43 |
| 2015 June | 36 | 6 | 42 |
| 2015 May | 48 | 9 | 57 |
| 2015 April | 38 | 19 | 57 |
| 2015 March | 50 | 11 | 61 |
| 2015 February | 32 | 10 | 42 |
| 2015 January | 23 | 8 | 31 |
| 2014 December | 21 | 10 | 31 |
| 2014 November | 31 | 13 | 44 |
| 2014 October | 27 | 18 | 45 |
| 2014 September | 26 | 12 | 38 |
| 2014 August | 33 | 14 | 47 |
| 2014 July | 26 | 10 | 36 |
| 2014 June | 39 | 10 | 49 |
| 2014 May | 38 | 19 | 57 |
| 2014 April | 48 | 6 | 54 |
| 2014 March | 54 | 14 | 68 |
| 2014 February | 41 | 20 | 61 |
| 2014 January | 32 | 12 | 44 |
| 2013 December | 52 | 18 | 70 |
| 2013 November | 36 | 12 | 48 |
| 2013 October | 56 | 18 | 74 |
| 2013 September | 34 | 16 | 50 |
| 2013 August | 25 | 22 | 47 |
| 2013 July | 47 | 26 | 73 |
| 2013 June | 31 | 15 | 46 |
| 2013 May | 33 | 17 | 50 |
| 2013 April | 17 | 11 | 28 |
| 2013 March | 7 | 1 | 8 |
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