Comparison of the Effectiveness of Home and Hospital-based PR in Candidate Patients With BLVR

Study Overview
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Brief Summary
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The recent years, the use of bronchoscopic lung volume reduction in emphysema patients instead of surgical operations has become widespread. Before this procedure, the implementation of Pulmonary Rehabilitation became a necessity. The inadequacy of the number of Pulmonary Rehabilitation Centers in our country and in our city and the increasing number of mentioned operations have increased the need for different exercise program applications. Prior to valve and coil applications in our study, changes in clinical conditions of patients will be examined if Pulmonary Rehabilitation is performed at home or in a hospital.

Detailed Description
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The records of emphysema patients referred to the Pulmonary Rehabilitation Unit for prophylactic pulmonary rehabilitation prior to bronchoscopic lung volume reduction will be recorded prospectively. Two parallel groups will be formed from patients with hospital-based pulmonary rehabilitation (Group 1) and those with home-based pulmonary rehabilitation (Group 2). The patient will receive an 8-week Pulmonary Rehabilitation Exercise Program and will be reevaluated after 8 weeks. The differences in the parameters of initial and rehabilitation end-tracing and the differences between the groups will be examined.

Official Title
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Comparison of the Effectiveness of Home and Supervised Pulmonary Rehabilitation in Candidate Patients With Bronchoscopic Lung Volume Reduction

Conditions
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Emphysema, Bronchoscopic Lung Volume Reduction, Hospital-based Pulmonary Rehabilitation, Home-based Pulmonary Rehabilitation

Intervention / Treatment
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* Other: Hospital-based pulmonary rehabilitation
* Other: Home-based pulmonary rehabilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with emphysema and bronchoscopic lung volume reduction procedures decided by chest physician Acceptance of participation in a 2-month Pulmonary Rehabilitation program. Exclusion Criteria: -Possible orthopedic, cardiovascular or psychological disturbance that may prevent exercising.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Two parallel groups will be formed from patients with hospital-based pulmonary rehabilitation (Group 1) and those with home-based pulmonary rehabilitation(Group 2).
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Hospital-based PR group<br>The patient will receive an 8-week supervised Pulmonary Rehabilitation Exercise Program at hospital | Other: Hospital-based pulmonary rehabilitation<br>* The patient will receive an 8-week Pulmonary Rehabilitation Exercise Program including breathing exercises, treadmill walking, cycle ergometer, arm ergometer training and strengthening trainning with free weights at hospital.<br>|
| Experimental: Home-based PR group<br>The patient will receive an 8-week Pulmonary Rehabilitation Exercise Program at home | Other: Home-based pulmonary rehabilitation<br>* The patient will receive an 8-week Pulmonary Rehabilitation Exercise Program including breathing exercises, free-walking, and strengthening training with free weights at home<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline distance covered in six-minute walk test at 8 weeks |  | 8 weeks | 
| Change from baseline modified Medical Council Dyspnea score at 8 weeks | The scale will rate the sensation of dyspnea as the person perceives it.The severity of dyspnea is rated on a scale of 0 to 4.0 point means no dyspnea perception and 4point means severe dyspnea perception. | 8 weeks | 
| Change from baseline Chronic Obstructive Airway Disease assesment test(CAT) score at 8 weeks | The COPD Assessment Test (CAT) is a questionnaire for people with COPD. It is designed to measure the impact of COPD on a person's life, and how this changes over time. Range of CAT scores from 0-40. Higher scores denote a more severe impact of COPD on a patient's life. | 8 weeks | 
| Change from baseline Forced Expiratory Volume in 1 second (FEV1) at 8 weeks |  | 8 weeks |