The Pros and Cons of Pulmonary Rehabilitation at Home

Abstract

There is little information regarding the benefit of pulmonary rehabilitation at home. What there is differs with respect to many factors: supervision provided, severity of disease, training modalities, intensity of the programme and environment defined as ‘home’. When compared to hospital programmes, home rehabilitation may result in smaller changes in exercise tolerance and quality of life, unless provided for a longer time with adequate supervision. However, home rehabilitation may be related to better adherence to an exercise programme and longer-term maintenance of improvements. Applying the principles of energy conservation with respect to activities of daily living is more appropriate at home and patients will benefit from ease of access. Cost effectiveness has not been adequately researched but a group approach run at a local hospital or community centre will probably be more cost effective than individual home based treatments. Where patients are able, the best approach in terms of effective treatment is attendance at out-patient based programmes. For patients too ill to attend, however, a comprehensive home care approach can reduce hospitalisation and emergency department visits. There is little information regarding the benefit of pulmonary rehabilitation at home. What there is differs with respect to many factors: supervision provided, severity of disease, training modalities, intensity of the programme and environment defined as ‘home’. When compared to hospital programmes, home rehabilitation may result in smaller changes in exercise tolerance and quality of life, unless provided for a longer time with adequate supervision. However, home rehabilitation may be related to better adherence to an exercise programme and longer-term maintenance of improvements. Applying the principles of energy conservation with respect to activities of daily living is more appropriate at home and patients will benefit from ease of access. Cost effectiveness has not been adequately researched but a group approach run at a local hospital or community centre will probably be more cost effective than individual home based treatments. Where patients are able, the best approach in terms of effective treatment is attendance at out-patient based programmes. For patients too ill to attend, however, a comprehensive home care approach can reduce hospitalisation and emergency department visits.