Twice versus three-times weekly pulmonary rehabilitation in a real-life clinical setting

Abstract

Aim : Our aim was to compare a less intensive but longer pulmonary rehabilitation programme (PRP) against a more intensive but shorter PRP. Methods : We carried out an observational, cohort study in a real-life clinical setting in patients primarily with chronic obstructive pulmonary disease (COPD). We compared standard outcomes in patients who were receiving 18 sessions of PRP delivered twice weekly over 9 weeks (Group 1) against similar patients receiving an identical PRP delivered three times weekly over 6 weeks (Group 2). Outcome measures were the St. George’s Respiratory Questionnaire (SGRQ), the Incremental Shuttle Walk Test (ISWT) and the number of hospital bed-days pre- and post-PRP. Results : Both groups showed statistically significant and clinically important improvements post-PRP. The largest effects were seen immediately post-PRP and waned over the following 12 months. Group 1 showed a larger improvement in ISWT immediately post-PRP (Group 1, +92 m versus Group 2 +64 m ( p =0.001), but there were no differences between groups at 6 ( p =0.67) or 12 months (p=0.96). There were no differences in SGRQ between groups immediately post-PRP ( p =0.09) or at 12 months ( p =0.78). There were no differences between groups in the number of hospital days 12 months prior to PRP versus 12 months post-PRP ( p =0.18). Conclusion : Twice weekly outpatient, multidisciplinary PRP over 9 weeks is as effective as three times weekly PRP over 6 weeks.