Tailored patient self-management and supervised, home-based, pulmonary rehabilitation for mild and moderate chronic obstructive pulmonary disease

• Published in: Journal of Physical Therapy Science Vol. 34; no. 1; pp. 49 - 59
• Main Authors: Paolucci, Teresa, Pezzi, Letizia, Bellomo, Rosa Grazia, Spacone, Antonella, Giannandrea, Niki, Matteo, Andrea Di, Prosperi, Pierpaolo, Bernetti, Andrea, Mangone, Massimiliano, Agostini, Francesco, Saggini, Raoul
• Format: Journal Article
• Language: English
• Published: Japan The Society of Physical Therapy Science 01.01.2022; Japan Science and Technology Agency
• Subjects: Chronic obstructive pulmonary disease; Dyspnea; Original; Quality of life; Rehabilitation; Ultrasound; Ultrasound; Rehabilitation; Quality of life
• ISSN: 0915-5287; 2187-5626
• DOI: 10.1589/jpts.34.49

[Purpose] Our study aimed to estimate the effects of a supervised, intensive, home-based-pulmonary-rehabilitation (HBPR) program for mild and moderate chronic-obstructive-pulmonary-disease (COPD) patients. [Participants and Methods] A retrospective, case-control study. Forty-three (N=43) patients were observed, divided into Treatment-Group (TG) and Control-Group (CG). The TG (N=23) underwent a 4-week training program, consisting of endurance and strength training sessions, performed 4-times per week. In addition, inspiration muscle training was performed, with a threshold device. The primary outcome was dyspnea improvements, measured by the modified-Borg-scale (mBS), and the secondary outcome was the determination of diaphragm excursion and function, using ultrasound (US) assessment to measure clinical parameters. [Results] The results suggested significantly improved mBS scores, measured for the ΔT0-T1 and ΔT0-T2 time points; improved diaphragm-excursion (Dia-Ex) at ΔT0-T1 and ΔT0-T2; and improved maximum Dia-Ex at ΔT0-T1 and ΔT1-T2 in the TG compared with the CG. Moreover, the results showed improvements over time for all parameters in the TG versus CG, suggesting a constant improvement in respiratory pathology. [Conclusion] A supervised HBPR plan was effective in reducing dyspnea by the mBS, and improving diaphragmatic function, as determined by US evaluation, and lastly improving quality of life in patients with mild-to-moderate COPD.