Pulmonary Rehabilitation at Home Versus at the Gymnasium
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Purpose
Short term efficacy of pulmonary rehabilitation for improving functional capacity and quality of life of chronic obstructive respiratory disease (COPD) patient is well known. However, there is an important gap between the scientific knowledge and the clinical use of pulmonary rehabilitation since a a very small number of patients benefit from this therapeutic intervention. We estimate that less than 1% of the 750 000 canadians suffering from COPD have access to a pulmonary rehabilitation program. We want to study the efficacy of a home-based rehabilitation program as a way to facilitate the access to rehabilitation.
| Condition | Intervention |
|---|---|
|
COPD |
Behavioral: Pulmonary rehabilitation (teaching and exercise) |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Intervention Model: Parallel Assignment Masking: Single Blind (Investigator) Primary Purpose: Prevention |
| Official Title: | Effects of a Home-based Versus a Hospital-based Outpatient Pulmonary Rehabilitation Program in Patients With COPD: a Multicenter, Randomized Trial |
- The dyspnea of the chronic respiratory questionnaire (CRQ) at 12 months is the primary outcome variable. [ Time Frame: The data collection was terminated in January 2007 and publication was done December 2008 ] [ Designated as safety issue: No ]Maltais F, Bourbeau J, Shapiro S, Lacasse Y, Perrault H, Baltzan M, Hernandez P, Rouleau M, Julien M, Parenteau S, Paradis B, Levy RD, Camp P, Lecours R, Audet R, Hutton B, Penrod JR, Picard D, Bernard S. Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Ann Int Med 2008;149:869-878.
- 2-CRQ total score and specific domains, exercise tolerance (6MWD and submaximal exercise test) and ADL at 4 months. [ Time Frame: The data collection was terminated in January 2007. ] [ Designated as safety issue: No ]
- 3-Health service utilization (physician and emergency department visits, hospitalizations) over the 1-year study period. [ Time Frame: The data collection was terminated in January 2007. ] [ Designated as safety issue: Yes ]
- 4 Intervention cost. [ Time Frame: The data collection was terminated in January 2007. ] [ Designated as safety issue: No ]
| Enrollment: | 252 |
| Study Start Date: | January 2004 |
| Study Completion Date: | January 2007 |
| Primary Completion Date: | January 2007 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Hospital-based
This group has to go at the hospital 3 times per week to do the exercise program.
|
Behavioral: Pulmonary rehabilitation (teaching and exercise)
After a 4-week education program, patients took part to home-based rehabilitation or outpatient hospital-based rehabilitation for 8 weeks. Patients were subsequently followed for 40 weeks to complete the one-year study.
|
|
Active Comparator: Home-Based
The group had to do the exercise program at home with indirect supervision (Polar watches and a phone call per week).
|
Behavioral: Pulmonary rehabilitation (teaching and exercise)
After a 4-week education program, patients took part to home-based rehabilitation or outpatient hospital-based rehabilitation for 8 weeks. Patients were subsequently followed for 40 weeks to complete the one-year study.
|
Detailed Description:
This article on the main outcome is available. Maltais F, Bourbeau J, Shapiro S, Lacasse Y, Perrault H, Baltzan M, Hernandez P, Rouleau M, Julien M, Parenteau S, Paradis B, Levy RD, Camp P, Lecours R, Audet R, Hutton B, Penrod JR, Picard D, Bernard S. Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Ann Int Med 2008;149:869-878.
Eligibility| Ages Eligible for Study: | 40 Years to 95 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Subject is able to ambulate. Defined as a 6MWD greater than 110 meters.
- Subject is diagnosed with COPD.
- 40 years-old and older
- Currently or previously smoking with a smoking history of at least 10 pack-years.
- Forced expiratory volume on one second (FEV1) after the use of a bronchodilator between 25 an 70% of the predicted value, and FEV1 to forced vital capacity ratio less than 70%.
- No previous diagnosis of asthma, left heart congestive heart failure (either radiographic evidence of pulmonary congestion, echocardiographic or ventriculographic evidence of a reduced ventricular ejection fraction), terminal disease, dementia or uncontrolled psychiatric illness.
- Never participated to a respiratory rehabilitation program and not staying or planning to stay in a long term care facility.
- Subject understands and is able to read and write French or English.
- MRC dyspnea scale of at least 2.
Exclusion Criteria:
- The need for supplemental oxygen at rest or during exercise will not be an exclusion criterion.
Contacts and Locations| Canada, British Columbia | |
| St-Paul's Hospital | |
| Vancouver, British Columbia, Canada, V6Z 1Y6 | |
| Canada, Nova Scotia | |
| Halifax Infirmary | |
| Halifax, Nova Scotia, Canada, B3H 3A7 | |
| Canada, Quebec | |
| CRMSBC/Centre Hospitalier Baie-des-Chaleurs | |
| Bonaventure, Quebec, Canada, G0C 1YO | |
| Jewish Rehabilitation Hospital | |
| Laval, Quebec, Canada, H7V 1R2 | |
| Hopital Hotel-Dieu de Levis | |
| Levis, Quebec, Canada, G6V 3Z1 | |
| Montreal Chest Institute | |
| Montreal, Quebec, Canada, H2X 2P4 | |
| Hopital Sacre-Coeur | |
| Montreal, Quebec, Canada, H4J 1C5 | |
| Mount Sinai Hospital | |
| Montreal, Quebec, Canada, H4W 1S7 | |
| CHA Enfant Jesus | |
| Quebec City, Quebec, Canada, G1J 1Z4 | |
| Hopital Laval | |
| Sainte-Foy, Quebec, Canada, G1V 4G5 | |
| Principal Investigator: | Francois Maltais, MD | Laval University - Hopital Laval |
More Information
No publications provided
| Responsible Party: | Francois Maltais, Laval University |
| ClinicalTrials.gov Identifier: | NCT00169897 History of Changes |
| Other Study ID Numbers: | ISRCTN32824512 |
| Study First Received: | September 13, 2005 |
| Last Updated: | November 11, 2010 |
| Health Authority: | Canada: Health Canada |
Keywords provided by Laval University:
|
COPD Exercise Self-management Rehabilitation |
Quality of life Health economy Cost effectiveness Health care utilization |
Additional relevant MeSH terms:
|
Pulmonary Disease, Chronic Obstructive Lung Diseases, Obstructive Lung Diseases Respiratory Tract Diseases |
ClinicalTrials.gov processed this record on May 21, 2013