Comparison of home-based and outpatient, hospital-based, pulmonary rehabilitation in patients with chronic respiratory diseases

Introduction. - The comprehensive care and personalized pulmonary rehabilitation (PR) of patients with chronic respiratory disease is effective regardless of the place of performance. The objective of this prospective observational study was to compare two types of care in an outpatient rehabilitation center, versus a home-based PR. Methods. - Two hundred and eighty-six patients were supported : 137 patients were included in outpatients (age : 61.2 +/- 10.8 years, BMI: 28.7 +/- 7.1), 149 in home-based PR (age: 62.9 +/- 12 years, BMI: 26.1 +/- 6.6). The choice between outpatient and home was a function of distance from the center and the patient's wishes. The outpatient care was done in groups of six, four times a week for 6 weeks. At home she was single, once a week for 8 weeks with continued physical activity independently of the other days a week depending on individual. action plan. The therapeutic education programs and psycho-social support were identical in both structures. The assessment included assessment of exercise tolerance test in 6 minutes stepper (TS6), anxiety and depression and quality of life. Results. - There were no incidents or accidents during the PR in the two structures. The exercise intolerance was significantly higher in patients TS6 home (332.9 +/- 154.8 versus 460.2 +/- 137.9 counts, P < 0.01). All the parameters studied, except for HAD score in the center, were improved significantly (P < 0.001) after the course. The evolution of the different scores was not significantly different between the ambulatory versus home. Conclusion. - The PR of chronic respiratory unselected patients is as safe and effective at home or in outpatient center on exercise tolerance and quality of life. Home-based PR is an alternative to outpatient care as long as all activities, physical training, therapeutic education and psychosocial support, are achieved. (c) 2012 Elsevier Masson SAS. All rights reserved.