Effect of pulmonary rehabilitation duration on exercise capacity and health‐related quality of life in people with chronic obstructive pulmonary disease (PuRe Duration Trial): A randomized controlled equivalence trial

Author:

Bishop Joshua A.12ORCID,Spencer Lissa M.13ORCID,Dwyer Tiffany J.1,McKeough Zoe J.1,McAnulty Amanda3,Leung Regina4,Alison Jennifer A.15ORCID

Affiliation:

1. Sydney School of Health Sciences, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia

2. Department of Physiotherapy Balmain Hospital Balmain New South Wales Australia

3. Department of Physiotherapy Royal Prince Alfred Hospital Camperdown New South Wales Australia

4. Department of Respiratory Medicine Concord Repatriation General Hospital Concord New South Wales Australia

5. Allied Health, Sydney Local Health District Sydney Australia

Abstract

AbstractBackground and ObjectiveThere is no strong evidence on the optimal duration of pulmonary rehabilitation (PR) programmes. The aim of the study was to determine whether an 8‐week PR programme was equivalent to a 12‐week PR programme in improving endurance exercise capacity in people with chronic obstructive pulmonary disease (COPD).MethodsParticipants with COPD were randomized to either an 8‐week (8‐wk Group) or 12‐week (12‐wk Group), twice weekly, supervised PR programme consisting of endurance and strength training and individualized self‐management education. Between group comparisons were made at completion of each programme (i.e., week 8 or week 12), for both programmes at week 12, and at 6–12‐month follow‐up. The primary outcome was endurance exercise capacity measured by the endurance shuttle walk test (ESWT) with the minimally important difference of 186 s set as the equivalence limit.ResultsSixty‐six participants [mean (SD); age 69 (7) years, FEV1 48 (17) %predicted] were randomized (33 per group). Between‐group comparisons demonstrated that the ESWT time was equivalent for the 12‐wk Group compared to the 8‐wk Group at programme completion [mean (95% CI)] [71 s (−61 to 203)], week 12 [70 s (−68 to 208)], and 6–12‐month follow‐up [93 s (−52 to 239)], though superiority of the 12‐wk Group could not be ruled out at each time point.ConclusionEquivalence was shown between 8‐and 12‐week PR programmes for endurance exercise capacity, but superiority could not be ruled out for the 12‐wk Group. Decisions about programme duration may depend on local waitlist times, healthcare budgets and patient preference.

Funder

Sydney Local Health District

Physiotherapy Research Foundation

Publisher

Wiley

Reference40 articles.

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3. An Official American Thoracic Society/European Respiratory Society Statement: Key Concepts and Advances in Pulmonary Rehabilitation

4. British Thoracic Society guideline on pulmonary rehabilitation in adults: accredited by NICE

5. A randomized, controlled trial comparing long‐term and short‐term exercise in patients with chronic obstructive pulmonary disease;Berry MJ;J Cardiopulm Rehabil,2003

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