Please select the eligibility criteria that correspond to the clinical trial below.
Title: Effects of a Home-based Versus a Hospital-based Outpatient Pulmonary Rehabilitation Program in Patients With COPD: a Multicenter, Randomized Trial
Brief Summary: Short term efficacy of pulmonary rehabilitation for improving functional capacity and quality of life of chronic obstructive respiratory disease (COPD) patient is well known. However, there is an important gap between the scientific knowledge and the clinical use of pulmonary rehabilitation since a a very small number of patients benefit from this therapeutic intervention. We estimate that less than 1% of the 750 000 canadians suffering from COPD have access to a pulmonary rehabilitation program. We want to study the efficacy of a home-based rehabilitation program as a way to facilitate the access to rehabilitation.


Options:
A: Inclusion Criteria:

* Subject is able to ambulate. Defined as a 6MWD greater than 110 meters.
* Subject is diagnosed with COPD.
* 40 years-old and older
* Currently or previously smoking with a smoking history of at least 10 pack-years.
* Forced expiratory volume on one second (FEV1) after the use of a bronchodilator between 25 an 70% of the predicted value, and FEV1 to forced vital capacity ratio less than 70%.
* No previous diagnosis of asthma, left heart congestive heart failure (either radiographic evidence of pulmonary congestion, echocardiographic or ventriculographic evidence of a reduced ventricular ejection fraction), terminal disease, dementia or uncontrolled psychiatric illness.
* Never participated to a respiratory rehabilitation program and not staying or planning to stay in a long term care facility.
* Subject understands and is able to read and write French or English.
* MRC dyspnea scale of at least 2.

Exclusion Criteria:

* The need for supplemental oxygen at rest or during exercise will not be an exclusion criterion.
B: Inclusion Criteria:

* Adults greater than 18 years of age and less than 64 years of age will be eligible for enrollment if the lead investigator and the treating physician agree that the patient meets the enrollment criteria which include the following:

  * patients with spirometrically confirmed COPD at high risk for repeat hospitalization or emergency department (ED) visits as predicted by hospital admission or ED visit in the previous 12 months for a COPD exacerbation,
  * chronic home use of oxygen, or
  * a course of systemic corticosteroid therapy in the preceding 12 months.

Exclusion Criteria:

* patients not expected to survive their hospitalization,
* presence of metastatic cancer,
* bed-bound individuals,
* non-English speaking patients, and
* patients unable to provide informed consent.
C: Inclusion Criteria:

* Confirmed Gold III/IV COPD
* Current or ex-smoker with a smoking history ≥ 10 pack-years
* At least one COPD exacerbation leading to hospitalization in the year before selection.

Exclusion Criteria:

* LTOT for another reason than COPD
* Severe concomitant disorder associated with a limited probability of survival (\< 6 months)
* Tracheostomy
* Long term oral corticosteroids therapy
D: Inclusion Criteria:

* participants must have a diagnosed COPD, be over 40 years and have no other medical barriers to participate in training at home with the e-health program.

Exclusion Criteria:

* medical barriers to participate in training at home with the e-health program.

Answer: A