Long-term effects of outpatient rehabilitation of COPD: A randomized trial

Rosa Güell, Pere Casan, Jose Belda, Mercé Sangenis, Fatima Morante, Gordon H. Guyatt, Joaquin Sanchis

Research output: Contribution to journalArticleResearchpeer-review

343 Citations (Scopus)


Objective: To examine the short- and long-term effects of an outpatient pulmonary rehabilitation program for COPD patients on dyspnea, exercise, health-related quality of life, and hospitalization rate. Setting: Secondary- care respiratory clinic in Barcelona. Methods: We conducted a randomized controlled trial with blinding of outcome assessment and follow-up at 3, 6, 9, 12, 18, and 24 months. Sixty patients with moderate to severe COPD (age 65 ± 7 years; FEV1 35 ± 14%) were recruited. Thirty patients randomized to rehabilitation received 3 months of outpatient breathing retraining and chest physiotherapy, 3 months of daily supervised exercise, and 6 months of weekly supervised breathing exercises. Thirty patients randomized to the control group received standard care. Results: We found significant differences between groups in perception of dyspnea (p < 0.0001), in 6-min walking test distance (p < 0.0001), and in day-to-day dyspnea, fatigue, and emotional function measured by the Chronic Respiratory Questionnaire (p < 0.01). The improvements were evident at the third month and continued with somewhat diminished magnitude in the second year of follow-up. The PR group experienced a significant (p < 0.0001) reduction in exacerbations, but not the number of hospitalizations. The number of patients needed to treat to achieve significant benefit in health-related quality of life for a 2-year period was approximately three. Conclusion: Outpatient rehabilitation programs can achieve worthwhile benefits that persist for a period of 2 years.
Original languageEnglish
Pages (from-to)976-983
Publication statusPublished - 1 Jan 2000


  • COPD
  • Health-related quality of life
  • Pulmonary rehabilitation


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