Effects of Home-Based Pulmonary Rehabilitation on Dyspnea, Exercise Capacity, Quality of Life and Impact of the Disease in COPD Patients: A Systematic Review

Abstract

Conventional pulmonary rehabilitation programs are used as therapies for the treatment of chronic obstructive pulmonary disease (COPD). However, this modality presents barriers that make rehabilitation difficult. For this reason, home-based pulmonary rehabilitation (HBPR) has been used to overcome these barriers. The objective was to systematically compare a structured program with HBPR or a control group for participants with COPD. The primary outcome was an improvement in symptoms in the level of dyspnea and secondary outcomes were parameters in lung function, exercise capacity, health-related quality of life (HRQoL) and the impact of the disease on the individual. The Medline (via PubMed), Virtual Health Library and Cochrane Library databases were searched until May 10, 2021. Randomized controlled trials were included without restrictions on the year of publication or language. The risk of bias was evaluated using the Cochrane risk-of-bias tool for randomized trials (RoB). Our results showed that there was a significant decrease in the level of dyspnea, (MD: 5.46; 95% CI: 1.97 to 8.96), increased distance covered (MD: 61.75; 95% CI: 42, 94 to 80.56, significant improvement in HRQoL (MD: −11.30; 95% CI: −19.81 to −2.79) and reduction in the impact of the disease (DM: −4.71; 95% CI: −7.95 to −1.47). All results found were comparing the intervention group versus the control group. To conclude we found a reduction in the levels of dyspnea, an increase in the distance covered on the six-minute walk test, improving HRQoL and decreasing the impact of the disease in COPD patients in home-based pulmonary rehabilitation.

Supplemental data for this article is available online at https://doi.org/10.1080/15412555.2021.2020234 .

Keywords:

• Physical therapy modalities
• pulmonary disease
• chronic obstructive
• exercise tolerance

Acknowledgements

We offer our deepest thanks to the FAPEMIG for the scholarships and to the to the Programa de Pós-graduação em Reabilitação e Desempenho Funcional (PPGReab), Physiotherapy Department of the Universidade Federal dos Vales do Jequitinhonha e Mucuri, that provided technical support for the development and implementation of this study.

Disclosure statement

We declare that there are no conflicts of interest.

Ethics approval

The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) platform on 20 September 2019 (PROSPERO; CRD42020151669).

Additional information

Funding

This study was financed in part by the Fundação de Amparo à Pesquisa do Estado de Minas Gerais (FAPEMIG) - APQ-00062-18.