Pulmonary rehabilitation · Delivering rehabilitation differently
Home-based rehabilitation for COPD using minimal resources
| Design | Randomised controlled equivalence trial |
|---|---|
| Treatment | Home-based pulmonary rehabilitation delivered with minimal resources |
| Control | Centre-based pulmonary rehabilitation |
| Population | 166 participants with COPD: 86 centre-based and 80 home-based |
| Follow-up | 12 months |
| Primary endpoint | Change in six-minute walk distance at end of rehabilitation |
| Result | Home-based rehabilitation was non-inferior for six-minute walk distance at end of rehabilitation, with the confidence interval not excluding superiority (mean difference favouring home 18.6 m, 95% CI -3.3 to 40.7). At 12 months the interval did not exclude inferiority (-5.1 m, -29.2 to 18.9). |
| Secondary endpoints | Quality of life, symptoms, longer-term maintenance, completion rates |
This home-based pulmonary rehabilitation model, delivered with minimal resources, produced short-term clinical outcomes that were equivalent to centre-based pulmonary rehabilitation.
The trial authors, in the published abstract
Attacks the access problem directly: most eligible patients never reach a centre-based programme, so equivalence at home is a substantial practical gain. Bourne 2023 later showed the same for long-term maintenance and readmissions.
Holland AE, Mahal A, Hill CJ, et al. Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial. Thorax 2017 Jan;72(1):57-65.