the program during exacerbation,6 combination of the program
with respiratory physical therapy,7 and involvement
of only subjects with very severe COPD.8 Maltais et al9
carried out the most important investigation of homebased
pulmonary rehabilitation programs in a randomized
study involving an adequate number of subjects and assessing
subject response in terms of dyspnea. They found
that a home-based pulmonary rehabilitation program with
a cycle ergometer was as efficacious for patients with
COPD as rehabilitation in a hospital setting.9 However,
training with a cycle ergometer implies costs to the patient,
which may be an obstacle to the widespread use of this
protocol.
Besides offering the same physiological benefits as exercise
performed in a hospital setting, a home-based pulmonary
rehabilitation program can be inexpensive and
easy to perform. In addition, the patient is kept close to
the family, which might help motivate the patient to reestablish
independence in terms of daily activities.
The hypothesis was that patients with COPD trained in
a home-based pulmonary rehabilitation program achieve
better physical capacity than patients without such training.
The aims of this study were (1) to develop an efficient,
low-cost, home-based pulmonary rehabilitation program;
(2) to evaluate the impact of the program on exercise
as measured by the 6-min walk test (6MWT) and treadmill
endurance test; and (3) to assess the effect on quality of
life in a group of subjects with COPD under partial supervision
compared with a control group.