EFFECTIVENESS AND SAFETY OF SUPERVISED HOME-BASED PHYSICAL TRAINING IN PATIENTS WITH COPD ON LONG-TERM HOME OXYGEN THERAPY: A RANDOMIZED TRIAL.
Patients with chronic obstructive pulmonary disease (COPD) in advanced disease stage who need long-term home oxygen therapy (LTHOT) have difficulty participating in outpatient pulmonary rehabilitation (PR) programs due to the severity of their disease, limitations involving transportation and mobility, high costs and issues related to patients’ safety and individual needs. Unsupervised home-based physical training (PT) is frequently used. The main objective of this study was to investigate the effectiveness of a supervised home-based PT program on exercise capacity and other outcomes in patients with COPD on LTHOT METHODS: In a randomized clinical trial, patients with COPD on LTHOT were allocated into two groups: supervised physical training group (PTG), consisting of patients who received home-based supervised muscle strength and endurance training in twice-weekly 60-minute sessions for 12 weeks; and unsupervised activity booklet group (BG), consisting of patients who received a booklet advising them to perform exercise twice a week during 12 weeks. All participants were assessed before and after the intervention in terms of exercise capacity (6-Minute Step-Test (6MST) and the 1-Minute Sit-to-Stand Test [STST]); dyspnea (Medical Research Council scale [MRC]); fatigue (Fatigue Severity Scale [FSS-BR]); and health status (COPD Assessment Test [CAT]) RESULTS: 44 patients were assessed (70±8 years, FEV1: 33±14%predicted) (PTG, n=22; BG, n=22). Only PTG presented significant improvement in 6MST (21±9 vs 14±1, p=0.001), MRC (3.3±1.0 vs 3.9±0.9, p=0.013), FSS-BR (5.0±1.4 vs 5.2±1.3, p=0.015) and CAT (21±8 vs 26±6, p=0.001). No adverse effects were observed.Supervised home-based PT was effective and safe in improving exercise capacity, dyspnea, fatigue and health status in patients with COPD on LTHOT.