Is Community based Pulmonary Rehabilitation effective for people with COPD?  A report of the CoHoRT study of pulmonary rehabilitation.

JC Waterhouse1 H Robinson1 S Lee1 L Dellipiani1 S Batty1 SJ Walters2  RA Lawson1

Sheffield Teaching Hospitals NHS Trust 1 and School of Health and Related Research, University of Sheffield 2

This UK Health Technology Assessment Board funded study compares Pulmonary Rehabilitation in a community or a hospital setting.  The same programme was provided by the same health care professionals in all settings

The programme was twice weekly for 6 weeks comprising exercises for strength and endurance with standardised education.  The primary outcome measure was the Endurance Shuttle Walking Test (ESWT).   Health Related Quality of life (HRQoL) was also assessed.

Subjects with an SpO2 of 91% or lower were excluded, as were those who desaturated to less than 80%.  Participants were randomly allocated. n =161 (m:f 88:73) Age = 69 (±7.8) FEV1 47% Predicted (±18).  Groups were well matched for baseline demographics and physiological variables.

There were no attributable adverse events.  ESWT improved greatly in both groups, with a non significant trend to higher benefit in the hospital treated group.

In this mildly hypoxaemic group, Pulmonary Rehabilitation has proven safe and effective in a community setting. 

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