Original Articles
Home vs Hospital-Based Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease: A Spanish Multicenter Trial
María Rosa Güella,
, Pilar de Lucasb, Juan Bautista Gáldizc, Teodoro Montemayord, José Miguel Rodríguez González-Morob, Amaia Gorostizac, Francisco Ortegad, José M. Bellónb, Gordon Guyatte
Corresponding author
mguellr@santpau.es
Correspondence: Dra M.R. Güell Departament de Pneumologia, Hospital de la Santa Creu i Sant Pau Pare Claret, 167 08025 Barcelona, Spain
Correspondence: Dra M.R. Güell Departament de Pneumologia, Hospital de la Santa Creu i Sant Pau Pare Claret, 167 08025 Barcelona, Spain
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Bellón, Gordon Guyatt" "autores" => array:9 [ 0 => array:4 [ "nombre" => "María Rosa" "apellidos" => "Güell" "email" => array:1 [ 0 => "mguellr@santpau.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Pilar" "apellidos" => "de Lucas" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Juan Bautista" "apellidos" => "Gáldiz" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 3 => array:3 [ "nombre" => "Teodoro" "apellidos" => "Montemayor" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] 4 => array:3 [ "nombre" => "José Miguel" "apellidos" => "Rodríguez González-Moro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 5 => array:3 [ "nombre" => "Amaia" "apellidos" => "Gorostiza" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] ] ] 6 => array:3 [ "nombre" => "Francisco" "apellidos" => "Ortega" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] ] ] 7 => array:3 [ "nombre" => "José M." "apellidos" => "Bellón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 8 => array:3 [ "nombre" => "Gordon" "apellidos" => "Guyatt" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff5" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Hospital de la Santa Creu i Sant Pau, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Hospital Gregorio Marañón, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Hospital de Cruces, Baracaldo, Vizcaya, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff3" ] 3 => array:3 [ "entidad" => "Hospital Virgen del Rocío, Sevilla, Spain" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff4" ] 4 => array:3 [ "entidad" => "McMaster University, Hamilton, Ontario, Canada" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff5" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "*" "correspondencia" => "Correspondence: Dra M.R. Güell Departament de Pneumologia, Hospital de la Santa Creu i Sant Pau Pare Claret, 167 08025 Barcelona, Spain" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2007-08-06" "fechaAceptado" => "2007-10-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec155035" "palabras" => array:5 [ 0 => "COPD" 1 => "Exercise tolerance" 2 => "Health-related quality of life" 3 => "Pulmonary rehabilitation, home care services" 4 => "Pulmonary rehabilitation, hospital-based" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec155036" "palabras" => array:5 [ 0 => "EPOC" 1 => "Capacidad de esfuerzo" 2 => "Calidad de vida relacionada con la salud" 3 => "Programa domiciliario de rehabilitación respiratoria" 4 => "Programa hospitalario de rehabilitación respiratoria" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">To compare the effects of a simple home pulmonary rehabilitation program and an intensive hospital-based program in terms of the exercise tolerance and health-related quality of life (HRQOL) of patients with severe chronic obstructive pulmonary disease (COPD).</p> <span class="elsevierStyleSectionTitle">Patients and Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Patients in this prospective, multicenter trial were randomized to 2 groups to receive hospital or home pulmonary rehabilitation. Patients in both groups attended 2 informative sessions about the disease and 4 physical therapy sessions. Patients in the hospital group then carried out a structured exercise program while home group patients performed low intensity exercises at home without supervision.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Twenty-eight patients were randomized to the hospital rehabilitation group and 23 to the home group. Both groups improved on the 6-minute walk test (mean difference, 8.7 m; <span class="elsevierStyleItalic">P</span> =.61). HRQOL measured with the Chronic Respiratory Questionnaire also improved in both groups, but the change was greater on the domain of emotional function in the hospital rehabilitation group (mean difference between groups, 0.58 on a scale for which the smallest clinically relevant difference is 0.5 points). The benefits were maintained in both groups 6 months after the programs ended.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">This study demonstrates that the improvement in exercise tolerance achieved by COPD patients with an unsupervised home pulmonary rehabilitation program is similar to the gains of patients in an intensive hospital-based program. However, the hospital program afforded greater benefit on the HRQOL domain of emotional function.</p>" ] "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">Estudiar el impacto de un programa simple de rehabilitación respiratoria domiciliario, comparado con uno intensivo hospitalario, sobre la capacidad de esfuerzo y la calidad de vida relacionada con la salud (CVRS) de los pacientes con enfermedad pulmonar obstructiva crónica.</p> <span class="elsevierStyleSectionTitle">Pacientes Y Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio prospectivo y multicéntrico en el que se aleatorizó a pacientes con EPOC grave en 2 grupos: hospital (GH) o domicilio (GD). En ambos los pacientes recibieron 2 sesiones de educación y 4 de fisioterapia. Los del GH realizaron un programa estructurado de ejercicio en el hospital y los del GD, un programa de ejercicio de baja intensidad en el domicilio, sin supervisión.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Se aleatorizó a 28 pacientes en el GH y a 23 en el GD. Ambos grupos mostraron una mejoría similar en la prueba de la marcha de 6 min (diferencia media de 8,7 m; p = 0,61). A pesar de que en ambos grupos mejoró la CVRS, medida con el Cuestionario de Enfermedad Respiratoria Crónica (CRQ), se objetivó un incremento mayor en el área de función emocional para el GH (diferencia media entre grupos: 0,58, en una escala donde un valor de 0,5 representa la diferencia mínima importante). Los beneficios del programa se mantuvieron en ambos grupos hasta 6 meses después de finalizarlo.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">El estudio muestra que un programa domiciliario de rehabilitación respiratoria sin supervisión produce una mejoría similar en la capacidad de esfuerzo de los pacientes con EPOC que un programa intensivo hospitalario. Sin embargo, éste alcanza mayores beneficios en el área de la función emocional de la CVRS.</p>" ] ] "NotaPie" => array:1 [ 0 => array:1 [ "nota" => "<p class="elsevierStyleNotepara">This study was partially funded by a grant from the Breathe Network, a thematic network for cooperative research of the Carlos III Health Institute (RTICISCIII-Red Respira).</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:35 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary rehabilitation. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 5 | 7 |
| 2024 October | 31 | 27 | 58 |
| 2024 September | 30 | 19 | 49 |
| 2024 August | 43 | 38 | 81 |
| 2024 July | 28 | 21 | 49 |
| 2024 June | 38 | 32 | 70 |
| 2024 May | 62 | 45 | 107 |
| 2024 April | 23 | 33 | 56 |
| 2024 March | 27 | 13 | 40 |
| 2024 February | 30 | 23 | 53 |
| 2023 March | 13 | 5 | 18 |
| 2023 February | 58 | 29 | 87 |
| 2023 January | 26 | 33 | 59 |
| 2022 December | 47 | 35 | 82 |
| 2022 November | 52 | 30 | 82 |
| 2022 October | 35 | 42 | 77 |
| 2022 September | 43 | 44 | 87 |
| 2022 August | 23 | 49 | 72 |
| 2022 July | 25 | 53 | 78 |
| 2022 June | 35 | 47 | 82 |
| 2022 May | 58 | 36 | 94 |
| 2022 April | 39 | 35 | 74 |
| 2022 March | 46 | 55 | 101 |
| 2022 February | 66 | 29 | 95 |
| 2022 January | 103 | 42 | 145 |
| 2021 December | 63 | 44 | 107 |
| 2021 November | 49 | 54 | 103 |
| 2021 October | 83 | 59 | 142 |
| 2021 September | 59 | 64 | 123 |
| 2021 August | 51 | 42 | 93 |
| 2021 July | 23 | 28 | 51 |
| 2021 June | 65 | 44 | 109 |
| 2021 May | 85 | 46 | 131 |
| 2021 April | 120 | 97 | 217 |
| 2021 March | 85 | 42 | 127 |
| 2021 February | 57 | 35 | 92 |
| 2021 January | 65 | 28 | 93 |
| 2020 December | 46 | 31 | 77 |
| 2020 November | 56 | 32 | 88 |
| 2020 October | 33 | 19 | 52 |
| 2020 September | 53 | 17 | 70 |
| 2020 August | 39 | 21 | 60 |
| 2020 July | 31 | 33 | 64 |
| 2020 June | 24 | 23 | 47 |
| 2020 May | 37 | 29 | 66 |
| 2020 April | 43 | 44 | 87 |
| 2020 March | 51 | 29 | 80 |
| 2020 February | 45 | 34 | 79 |
| 2020 January | 43 | 43 | 86 |
| 2019 December | 40 | 28 | 68 |
| 2019 November | 41 | 39 | 80 |
| 2019 October | 65 | 40 | 105 |
| 2019 September | 50 | 29 | 79 |
| 2019 August | 43 | 27 | 70 |
| 2019 July | 29 | 29 | 58 |
| 2019 June | 27 | 33 | 60 |
| 2019 May | 28 | 22 | 50 |
| 2019 April | 37 | 73 | 110 |
| 2019 March | 39 | 40 | 79 |
| 2019 February | 34 | 28 | 62 |
| 2019 January | 14 | 19 | 33 |
| 2018 December | 26 | 27 | 53 |
| 2018 November | 55 | 45 | 100 |
| 2018 October | 39 | 32 | 71 |
| 2018 September | 21 | 15 | 36 |
| 2018 May | 11 | 0 | 11 |
| 2018 April | 8 | 10 | 18 |
| 2018 March | 5 | 18 | 23 |
| 2018 February | 6 | 14 | 20 |
| 2018 January | 5 | 23 | 28 |
| 2017 December | 10 | 15 | 25 |
| 2017 November | 3 | 19 | 22 |
| 2017 October | 21 | 44 | 65 |
| 2017 September | 5 | 28 | 33 |
| 2017 August | 8 | 22 | 30 |
| 2017 July | 20 | 27 | 47 |
| 2017 June | 42 | 33 | 75 |
| 2017 May | 33 | 8 | 41 |
| 2017 April | 27 | 12 | 39 |
| 2017 March | 50 | 15 | 65 |
| 2017 February | 18 | 6 | 24 |
| 2017 January | 12 | 9 | 21 |
| 2016 December | 12 | 12 | 24 |
| 2016 November | 28 | 14 | 42 |
| 2016 October | 12 | 15 | 27 |
| 2016 September | 20 | 18 | 38 |
| 2016 August | 13 | 3 | 16 |
| 2016 July | 15 | 6 | 21 |
| 2016 June | 3 | 0 | 3 |
| 2016 May | 2 | 0 | 2 |
| 2016 April | 1 | 0 | 1 |
| 2016 March | 5 | 0 | 5 |
| 2016 February | 2 | 0 | 2 |
| 2016 January | 2 | 0 | 2 |
| 2015 December | 3 | 0 | 3 |
| 2015 November | 2 | 0 | 2 |
| 2015 October | 69 | 10 | 79 |
| 2015 September | 65 | 18 | 83 |
| 2015 August | 65 | 16 | 81 |
| 2015 July | 80 | 9 | 89 |
| 2015 June | 76 | 18 | 94 |
| 2015 May | 70 | 11 | 81 |
| 2015 April | 55 | 13 | 68 |
| 2015 March | 75 | 7 | 82 |
| 2015 February | 46 | 7 | 53 |
| 2015 January | 52 | 12 | 64 |
| 2014 December | 79 | 11 | 90 |
| 2014 November | 60 | 10 | 70 |
| 2014 October | 62 | 11 | 73 |
| 2014 September | 54 | 9 | 63 |
| 2014 August | 61 | 11 | 72 |
| 2014 July | 54 | 12 | 66 |
| 2014 June | 55 | 12 | 67 |
| 2014 May | 74 | 13 | 87 |
| 2014 April | 63 | 16 | 79 |
| 2014 March | 89 | 13 | 102 |
| 2014 February | 73 | 12 | 85 |
| 2014 January | 36 | 7 | 43 |
| 2013 December | 45 | 16 | 61 |
| 2013 November | 50 | 13 | 63 |
| 2013 October | 64 | 11 | 75 |
| 2013 September | 48 | 14 | 62 |
| 2013 August | 54 | 16 | 70 |
| 2013 July | 52 | 21 | 73 |
| 2013 June | 41 | 7 | 48 |
| 2013 May | 34 | 10 | 44 |
| 2013 April | 24 | 8 | 32 |
| 2013 March | 10 | 2 | 12 |
Show all
