A subgroup analysis reported significant differences in the promotion of physical activity based on baseline physical activity levels and the type of instrument used to assess levels of physical activity .
Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial
Background Pulmonary rehabilitation is a cornerstone of care for COPD but uptake of traditional centre-based programmes is poor . We assessed whether home-based pulmonary rehabilitation , delivered using minimal re sources , had equivalent outcomes to centre-based pulmonary rehabilitation . Methods A r and omised controlled equivalence trial with 12 months follow-up . Participants with stable COPD were r and omly assigned to receive 8 weeks of pulmonary rehabilitation by either the st and ard outpatient centre-based model , or a new home-based model including one home visit and seven once-weekly telephone calls from a physiotherapist . The primary outcome was change in 6 min walk distance ( 6MWD ) . Results We enrolled 166 participants to receive centre-based rehabilitation  ( n=86 ) or  home-based rehabilitation ( n=80 ) . Intention-to-treat analysis confirmed non-inferiority of home-based rehabilitation for 6MWD at end-rehabilitation and the confidence interval ( CI ) did not rule out superiority ( mean difference favouring home group 18.6 m , 95 % CI −3.3 to 40.7 ) . At 12 months the CI did not exclude inferiority ( −5.1 m , −29.2 to 18.9 ) . Between-group differences for dyspnoea-related quality of life did not rule out superiority of home-based rehabilitation at programme completion ( 1.6 points , −0.3 to 3.5 ) and groups were equivalent at 12 months ( 0.05 points , −2.0 to 2.1 ) . The per- protocol analysis showed the same pattern of findings . Neither group maintained postrehabilitation gains at 12 months . Conclusions This home-based pulmonary rehabilitation model , delivered with minimal re sources , produced short-term clinical outcomes that were equivalent to centre-based pulmonary rehabilitation . Neither model was effective in maintaining gains at 12 months . Home-based pulmonary rehabilitation could be considered for people with COPD who can not access centre-based pulmonary rehabilitation . Trial registration number NCT01423227 , clinical trials.gov
A subgroup analysis reported significant differences in the promotion of physical activity based on baseline physical activity levels and the type of instrument used to assess levels of physical activity .