Respiratory Trials·org

Topic

Pulmonary rehabilitation

Exercise training and its effect on symptoms, admissions, and survival.

The problem with pulmonary rehabilitation is not whether it works but who gets it. Most eligible patients never access or complete a programme, which is why the delivery trials matter more than further efficacy trials.

Home-based rehabilitation delivered with minimal resources matched centre-based programmes on short-term outcomes (Holland 2017). Over a year, both telerehabilitation and entirely unsupervised home training cut readmissions by roughly 40% against usual care and maintained exercise gains (Bourne 2023) — with unsupervised training performing as well as supervised.

In routine practice, starting rehabilitation within 90 days of a COPD admission was associated with 17% fewer readmissions over the following year (Lindenauer 2021), though confounding by indication is the obvious caveat in an observational cohort.

Delivering rehabilitation differently

Trial Year Therapy Effect Finding
Bourne 2023 2023 Telerehabilitation and unsupervised home training Home telerehabilitation and unsupervised training both cut readmissions by around 40%
Holland 2017 2017 Home-based pulmonary rehabilitation Home-based rehabilitation matched centre-based programmes on short-term outcomes

Rehabilitation after admission

Trial Year Therapy Effect Finding
Lindenauer 2021 observational cohort 2021 Early pulmonary rehabilitation Starting rehabilitation within 90 days of a COPD admission was associated with 17% fewer readmissions

Key references

Guidelines, standards and reviews for this topic.