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Evaluation of the intervention of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease Cover

Evaluation of the intervention of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease

Open Access
|Aug 2021

Figures & Tables

Figure 1

PRISMA flowchart.
PRISMA flowchart.

Baseline characteristics of included studies_

Author/year/country or regionSubject characteristicsInterventionControlTime pointsMeasuring tools
Daniel Langer/2015/USAC: 10I: 10Age: >75Stable COPDMTL IMT—mechanical threshold loading (MTL)TFRL IMT— tapered flow resistive loading (TFRL)8 weeks-Inspiratory muscle strength-Inspiratory muscle endurance-PF
Dimitra Nikoletou/2015/BritainC: 34;I: 34.Stages: moderate to severeAge: >50 yearsBEIMT with a threshold loading deviceNot to train the respiratory muscles7 weeks-PImax-SNIP-diaphragm contractility (Pdi,tw)-ISWT-RME-CRDQ-HADS-the SF-36
Fahrahnaz Mohammadi/2015/Iran40 patients:I: 20C: 20Stages: GOLD 2–3Age: no limitEDU+LLE+BEThree one-hour sessions of face-to-face + the correct methods of walking + drug therapyDrug therapy.7 weeks-SF-12-FSS-BI
Marieke L Duiverman/2011/The NetherlandsI: 24C: 32Stages: III or IVAges: 40–76EDU 12 weeksNIPPV+PRAt home:EDU 12 weeksPR6, 12, 18, 24 M-CRQ-MRF-28-GARS-HADS-FEV1-MRC-6MWD
María Rosa Güell/2007/Spain51 patients:I: 23C: 28Stage IIIAge:I: 66 (5.8)C: 63.2 (6.6)EDU+BE\ULE\LLE:unsupervised street walking daily at a pace of 4 km/h marked by a podometerwent up and down stairs for 5 minutes before and after each walkHospital:EDU+BE\ULE\LLE:3 times per weekRespiratory muscle function.Arm muscle exercise tests.Leg muscle exercise test.CRQ
Juliana M. de Sousa Pinto/2014/SpainI: 29C: 21Stages: severe and very severeAge: <80BE+ULE+LLEEndurance training: walking, stair climbing, cycling.standard medical therapy + inhaler devices and nebulizer therapy.At home:standard medical therapy + the nursing counseling session.12 weeks-The Spirometer Jaeger MasterScope model-SGRQ-LCADL-6MWD-The Borg scale-a pulse oximeter
Atsuyoshi Kawagoshi/2014/JapanI: 20C: 19Stage: stableAge: Elderly agedBE+ULE+LLEPR + pedometer useAt home:BE+ULE+LLEPP1 Y-CRQ-BODE-6MWD-FVC-FVC1
Tristan Bonnevie/2018/FranceC: 27; I: 24 Stages: severe to very severeAge: >18 yearsBE+ULE+LLENMESOutpatient or home:EDU+BE+ULE+LLEmuscle strength training8 weeks-6MWT-VO2peak-Wmax-mMRC-SGRQ
Xujingjuan/2016/ChinaC: 62; I: 63Stages: modified or aboveBE+ULE+LLEImproved lung-rehabilitation training program (including breathing training + routine care) + relaxation training +LLE +ULEBEincluding breathing training + routine care12 weeks-6MWT-mMRC-PF-SGRQ
Fernanda Dultra Dias/2013/BrazilI: 13C: 10.Stages: stableAge: >40EDU+BE+LLEa protocol at home with aerobic and muscle strength exercisesEDUonly instructions to perform breathing and stretching exercises2 M-ISWT and VLIT-strength and endurance test (MIP and MEP)-AQ-20
W-T. Liu/2008/Taiwan, China48 patients:I: 24C: 24Stages: moderate to severeAge: 40–80 yearsLLE:Walking at a speed following the tempo of the musicAt home:same protocol and take daily walking exercise4 weeks for 3 M and again after 1 yr-PF-ISWT-SF-12-BMI
Chiung-Fang Ho/2012/Taiwan, China41 patients:I: 20C: 21Stage II–IIIAge: 74 ± 10.3 yearsLLE:The paced walking to music.at initial speed was set at 80% VO2 peak and increased gradually.At Home:Receive the usual care.12 weeks-ISWT-PFT-HRQOL-SGRQ-Health resource utility
Marcel du Moulin/2009/Germany20 patients:I: 10C: 10Stage: moderateAge:I: 67 (63–72)C: 72 (69–77)EDU+3WReceive an individualized training plan.LLE:daily activities. (walking) with a pedometerEDU+3Wcarry out their activities of daily living in their accustomed way.after 3 M and 6 M.-CRQ-PFT-6MWT
Elizabeth J Horton/2017/UKC: 142I: 145Stages: 2–5Mean age: 68LLEStructure unsupervised home exerciseCenter-based exercise: LLE7 W;6 M-CRQ-SR-HADS-PRAISE-ISWT-ESWT
P.de Roos/2016/HollandC: 26I: 26Stages: Stable and moderateMean age: 69.4 and 71.0LLE10 week supervised exercise training and home-based walk.Center-based: standard medical care10 weeks-The accelerometry-Physical Activity Scale for the Elderly;-6MWT;-CRQ;-Exercise Self-Regulatory Efficacy Scale
Wangxin/2013/ChinaI: 17C: 18Stages: very severeAge: 58–74 yearsLLE+Oxygen therapy + drug therapy + noninvasive positiveExercise under pressure ventilationOxygen therapy + drug therapy6 M-6MWD-Brog-SGRQ
Cristiane O Pradella/2015/BrazilI: 29C: 15Age: 40–75 yearrsLLE+ULE(1) warm-up, (2) aerobic activity, (3) stretching, and (4) relaxation.At home:no intervention.8 weeks-SGRQ-6MWT-treadmill endurance test-spirometry
Júlio C/2010/Italy85 patients:HOME: 33Outpatient: 29C: 23Stage: GOLD I–IVAge:H: 66.4 ± 9.5O: 71.3 ± 6.7C: 70.8 ± 8.7(1) EDULLE+ULEAerobic=walks on flat ground and strengthening exercises(2) Outpatient:EDUULE+LLEaerobic and strengthening exercises(3) C: At homeNot perform any PRthree mornings a week for three months.-BMI-6MWT-BODE-mMRC dyspnea scale
Anne E Holland/2016/AustraliaC: 86I: 80Stages: stableMean age: 69Structure Home Exercise (aerobic\LLE) with Physical Therapists Visiting and Telephone SupervisionOutpatient:twice weekly outpatient group-based supervised program,8 weeks1 Y-6MWD-modified Medical Research Council dyspnea scale-CRQ-PRAISE-HADS
François Maltais/2008/America252 patients:I: 126C: 126Stages: II–IVMean age: 66EDU+Aerobic and strength exercise: ?Outpatient:EDU+LLE:Leg cycling8 weeks-CRQ-SGRQ-PFT-6MWT
Carol McFarland, P T/2012/AmericaI: 13C: 11Stages: Mild and moderateMean ages: 72.2 and 76.2Home visits +EDUA: aerobic conditioningHome visits +EDUB: At home:functional strength training8 weeks16 weeks-CRQ-Geriatric Depression Scale (GDS)-2MWT

Outcomes of home-based intervention of included studies_

Author/year/countryInterventionControlOutcome



EDUBELLEULEAerobic/Resistance exerciseAdd-onOur patient or hospitalHomeHRQOLDyspneaPhysical activity/Exercise capacityPFAnxiety/DepressionOthers
Daniel Langer/2015/AmericaMTLTFRLPF: no improvement and no difference (both groups)PIMAX (inspiratory muscle strength) and Tlim (inspiratory muscle endurance)√ (TFRL>MTL)
Dimitra Nikoletou/2015/Britain. –DeviceNo trainingSF-36√ (emotion, mental, health)ISWT: No difference between groupsPImax (r=0.6, P = 0.04)√HADS√ (P = 0.03) Perception of wellbeing√
Fahrahnaz Mohammadi /2015/Iran– .Drug therapySF-12 (21.94 vs 54.63, P < 0.001)Fatigue √FSS (21.94 vs 54.63, P < 0.001)BI (95.55 vs 80.88, P = 0.001) ADL:√
Marieke L Duiverman/2011/The NetherlandsNIPPVBE+LLECRQ [96.8 (15.3) vs. 87.1 (18.9)]; P = 0.044√ MRF-28√MRC√GARS (−3.8 points (−7.4 to −0.4; P = 0.03))√6MWD√ (77.3 m (46.4 to 108.0; P < 0.001)FEV1√ (115 ml (19 to 211; P = 0.019)).HADS√ (−7.8 to 0.0; P = 0.05)
María Rosa Güell/2007/SpainCRQI:Dys:√C: All HRQOL scores were higher in hospital training6MWT: increased but no difference. Arm strength: had improved and not difference.PImax Both groups had improvement
Juliana M. de Sousa Pinto/2014/SpainStandard medical therapyI: SGRQ (P < 0.001) √Activity domain (P = 0.008)Impact domain (P < 0.001)I: LC-ADL (P < 0.01)√Improve breathlessnessC: No differenceI 6MWD: (P = 0.008)
Atsuyoshi Kawagoshi/2014/JapanPedometerBE+ULE+LLE(Both groups) CRQ (r = 0.540, P = 0.004)√BODE (r = 0.656, P = 0.001) MRC:√(PR+P)(both groups) 6MWD (r = 0.401, P = 0.038)Both group: Imax√Qf\walking time√(PR+P)
Tristan Bonnevie/2018/FranceNMESEDU+BE+ ULE+ LLE+ Muscle strength trainingSGRQ (P = 0.01)√ (both groups)mMRC (P < 0.01) (both groups)6MWT: (P < 0.01) (both groups)
Xujingjuan/2016/ChinaBESGRQ (P < 0.05)mMRC√, P < 0.056MWT, P < 0.05
Fernanda Dultra Dias/2013/BrazilEDU+BE+ stretching exercises– not improvedISWT: no difference (both groups)Respiratory endurance improved in I group.Biweekly supervision plays important role
W-T. Liu,/2008 /TaiwanMusicLLESf-12√Dyspnea ratingBorg scaleISWT√Clinical outcomes: Endurance walking exercise compliance
Chiung-Fang Ho/2012/TaiwanMusicUsual careSGRQ: √Borg scaleRPE-DResting dyspnea√Fatigue√ISWT:√No differential change
Marcel du Moulin/2009/GermanyUsual careCRQ:√(P = 0.027)CRQ (dyspnea)√ (P = 0.014)CRQ (fatigue)√ (P = 0.016)6MWT √ 6MWT in meters (primary end-point, p = 0.033FEV1: P = 0.007
Elizabeth J Horton/2017/UKResistance exerciseCenter: LLECRQ-dyspnea√ (both groups)-7w Non-inferiorESWT (both groups)√ Non-inferiorCRQ-emotion (within group√ Non-inferior)– .
P. de Roos/2016/Holland. –Center: Medical care I PA: (26.1min/d, 95%CI 7.3–44.9); 6MWD: (P < 0.01)
Wangxin/2013/ChinaNIPPVDrugI SGRQ (t = 11.724, P < 0.05)I Brog (t = 13.665, P < 0.05)I 6MWD (t = 6.787, P < 0.05)
Cristiane O Pradella/2015/Brazil– .No interventionDecreased by >4 units in all SGRQ domains√ no difference in C group.6MWT (65.7 ± 83.1m vs 5.5 ± 92.9 m, P < 0.05)The endurance test (316.6 ± 81.8 m vs 31.2 ± 419.7 m, P < 0.05)
Júlio C/2010/ItalyNo PRBODE:√(H\O) no difference between the outpatient and at-home groups (P = 0.90)6MWT √(H\O) no difference between the outpatient and at-home groups (P = 0.44)The control group no change
Anne E Holland/2016/Australia(aerobic)Edu+LLE +ULENo difference between groups6MWD (No difference between groups)
François Maltais/2008 /America(aerobic)CRQ: SGRQ: All similar efficacy6MWT: 95%CI Similar efficacyLung function remains stable.
Carol McFarland/2012/America(aerobic)EDU+function strength trainingCRQ (P < 0.05)√A=B Especially in dyspneaOnly group A had a clinically significant improvement in walking distanceGDS (P < 0.05) √(both A and B)
DOI: https://doi.org/10.2478/fon-2021-0012 | Journal eISSN: 2544-8994 | Journal ISSN: 2097-5368
Language: English
Page range: 99 - 112
Submitted on: Sep 11, 2020
Accepted on: Nov 21, 2020
Published on: Aug 18, 2021
Published by: Shanxi Medical Periodical Press
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year

© 2021 Ye Zhang, Na-Ping Xu, Bei-Rong Mo, Xian-Liang Liu, Ya-Chang Lin, published by Shanxi Medical Periodical Press
This work is licensed under the Creative Commons Attribution 4.0 License.