期刊
THORAX
卷 76, 期 3, 页码 264-271出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/thoraxjnl-2020-215281
关键词
pulmonary rehabilitation; equipment evaluations
资金
- National Institute for Health Research (NIHR) Research for Patient Benefit grant [PB-PG-0816-20022]
- NIHR Clinical Doctoral Research Fellowship (NIHR) [300566]
- NIHR Clinical Doctoral Research Fellowship [ICA-CDRF-2017-03-018]
- NIHR Clinical Trials Fellowship [CTF-2017-06-005]
- British Lung Foundation [IPFPG17-15]
- NIHR Doctoral Research Fellowship [DRF-2015-08-004]
- NIHR [PB-PG-0816-20022, CDF-2017-10-009]
- NIHR Applied Research Collaboration South London (NIHR ARC South London) at King's College Hospital NHS Foundation Trust
- National Institute for Health Research (NIHR)
- National Institutes of Health Research (NIHR) [CTF-2017-06-005, PB-PG-0816-20022, DRF-2015-08-004, ICA-CDRF-2017-03-018] Funding Source: National Institutes of Health Research (NIHR)
In patients with COPD, pulmonary rehabilitation using minimal equipment produces clinically significant benefits in exercise capacity and health-related quality of life that are non-inferior to rehabilitation using specialist equipment. This study supports the provision of pulmonary rehabilitation using minimal exercise equipment in areas where access to specialist exercise equipment is limited.
Background Many trials supporting the benefits of pulmonary rehabilitation (PR) have used specialist exercise equipment, such as treadmills and cycle ergometers. However, access to specialist equipment may not be feasible in some settings. There is growing interest in delivering PR programmes with minimal, low-cost equipment, but uncertainty remains regarding their efficacy compared with programmes using specialist equipment. Methods Using propensity score matching, 318 consecutive patients with COPD undergoing supervised PR using minimal equipment (PR-min) were compared 1:1 with a control group of 318 patients with COPD who underwent supervised PR using specialist equipment (PR-gym). A non-inferiority analysis was performed for the primary outcome (incremental shuttle walk (ISW)) and secondary outcomes (Chronic Respiratory Disease Questionnaire (CRQ)-domain and total scores). Results Similar improvements in ISW and CRQ-domains were observed in PR-min and PR-gym groups (mean difference ISW: 3 m (95% CI -16 to 9); CRQ-total: 0.9 (95% CI -2.7 to 4.5)). The 95% CI between group differences for ISW and CRQ-total did not cross the predefined non-inferiority margins. However, completion rates were lower in PR-min compared with PR-gym (64% vs 73%; p=0.014). Conclusions In patients with COPD, PR delivered using minimal equipment produces clinically significant benefits in exercise capacity and health-related quality of life that are non-inferior to rehabilitation delivered using specialist equipment. This study provides support for the provision of PR using minimal exercise equipment, particularly in areas where access to specialist exercise equipment is limited.
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