American Thoracic Society International Conference

American Thoracic Society International Conference

Source:

Frei A, et al. New Insights in Pulmonary Rehabilitation. Presented at: American Thoracic Society International Conference; May 14-19, 2021 (virtual meeting).

Disclosures: Frei reports no relevant financial disclosures.
June 17, 2021
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Home-based training program promising approach to maintain effects of pulmonary rehab

Source:

Frei A, et al. New Insights in Pulmonary Rehabilitation. Presented at: American Thoracic Society International Conference; May 14-19, 2021 (virtual meeting).

Disclosures: Frei reports no relevant financial disclosures.
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A home-based exercise training program for patients with COPD after pulmonary rehabilitation was associated with high adherence and a benefit in functional exercise capacity but no change in dyspnea from baseline to 1 year.

“Exercise training is an important component of pulmonary rehabilitation in COPD, but the great majority of patients never follow such programs or failed to maintain training after they completed rehabilitation,” Anja Frei, PhD, senior researcher in the Epidemiology, Biostatistics and Prevention Institute at the University of Zurich, said during a presentation at the American Thoracic Society International Conference.

COPD
Source: Adobe Stock.

The HOMEX-1 randomized controlled trial evaluated the HOMEX exercise training program, which follows strength training exercises targeting the upper and lower limbs 6 days per week with increasing intensity levels and a coach, who completes three home visits and 17 phone calls. The HOMEX program is home-based, with daily exercises that last 20 minutes and require minimal equipment aside from a chair and elastic bands.

The HOMEX-1 randomized controlled trial included 123 patients with COPD (mean age, 66.8 years; 49.6% women) recruited after pulmonary rehabilitation in four clinics. Patients were randomly assigned to the HOMEX training program (intervention group; n = 53) or usual care (control group; n = 70) for 1 year.

The primary outcome was change in dyspnea on the Chronic Respiratory Questionnaire (CRQ). Secondary outcomes included change in exercise capacity, health-related quality of life, health status, and COPD symptoms and exacerbations.

In total, 104 patients with COPD completed the 1-year study and follow-up assessments. Researchers observed no difference in change in dyspnea (CRQ mean difference, 0.28; 95% CI, –0.23 to 0.8; P = .027), according to the abstract.

The researchers observed a significant difference in exercise capacity using the 1-minute sit-to-stand test favoring the intervention group (mean difference, 2.6 repetitions; 95% CI, 0.22-5.03; P = .033). There was no difference in other secondary outcomes.

In addition, patient adherence to the HOMEX exercise program was high, with 38 patients in the intervention group completing HOMEX training through 1 year and 43 patients for at least 10 months.

“Our results show that the HOMEX training provided benefit in functional exercise capacity, assessed by the 1-minute sit-to-stand test, but no benefit in other assessments were found,” Frei said. “However, we conclude that the HOMEX intervention is a promising approach to maintain the effects after pulmonary rehabilitation in the long term.”

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