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Short-course pulmonary rehabilitation and exacerbations and activity of COPD patients over 1 year

Introduction: Pulmonary rehabilitation programme (PRP) varies in duration from a few weeks to more than a year. PRP shorter than 6–8 weeks are generally less effective. Aims: To assess whether a short course PRP with periodic reinforcement exercise training and phone call reminders would help to reduce readmissions for acute exacerbation (AECOPD) and increase activity in COPD patients. Methods: This was a randomized controlled trial. Patients in the invention group received out-patient physiotherapy training for 4-8 sessions, 2 hours each time, 1-2 times weekly. Each subject in the intervention group (IG) would have at least 4-8 weeks supervised training by a trained physiotherapist. Our case manager contacted the subjects by phone every 2 weeks to provide support and reinforcement for continuous exercise at home for one year. The usual care group (UG) received usual care without physiotherapist or case manager intervention. Activities of all patients were assessed by an activity monitor GT3XP (Actigraph, Pensacola, USA). Results: Total 136 subjects were included and randomised (68 in IG and 68 in UG). The age, gender and FEV1% predicted were 75.0±6.7years, 132 males, and 47.0±16.2% respectively. The mean number of readmissions for AECOPD in the IG was less than the UG at 12 months (1.06 vs 1.72 times, p=0.014). Time to first readmission was shorter in the UG than the IG at 12 months (122.4 vs 146.8days, p=0.005). At 12 months, there was no change in activity measured by steps per day between the IG and UG groups. Conclusions: Short course pulmonary rehabilitation could decrease the number of readmissions and lengthen the time of readmissions for AECOPD.