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dc.contributor.authorHolland, AE
dc.contributor.authorMahal, A
dc.contributor.authorHill, CJ
dc.contributor.authorLee, AL
dc.contributor.authorBurge, AT
dc.contributor.authorCox, NS
dc.contributor.authorMoore, R
dc.contributor.authorNicolson, C
dc.contributor.authorO'Halloran, P
dc.contributor.authorLahham, A
dc.contributor.authorGillies, R
dc.contributor.authorMcDonald, CF
dc.date.accessioned2020-12-21T01:56:34Z
dc.date.available2020-12-21T01:56:34Z
dc.date.issued2017-01-01
dc.identifierpii: thoraxjnl-2016-208514
dc.identifier.citationHolland, A. E., Mahal, A., Hill, C. J., Lee, A. L., Burge, A. T., Cox, N. S., Moore, R., Nicolson, C., O'Halloran, P., Lahham, A., Gillies, R. & McDonald, C. F. (2017). Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial. THORAX, 72 (1), pp.57-65. https://doi.org/10.1136/thoraxjnl-2016-208514.
dc.identifier.issn0040-6376
dc.identifier.urihttp://hdl.handle.net/11343/256722
dc.description.abstractBACKGROUND: Pulmonary rehabilitation is a cornerstone of care for COPD but uptake of traditional centre-based programmes is poor. We assessed whether home-based pulmonary rehabilitation, delivered using minimal resources, had equivalent outcomes to centre-based pulmonary rehabilitation. METHODS: A randomised controlled equivalence trial with 12 months follow-up. Participants with stable COPD were randomly assigned to receive 8 weeks of pulmonary rehabilitation by either the standard outpatient centre-based model, or a new home-based model including one home visit and seven once-weekly telephone calls from a physiotherapist. The primary outcome was change in 6 min walk distance (6MWD). RESULTS: We enrolled 166 participants to receive centre-based rehabilitation (n=86) or home-based rehabilitation (n=80). Intention-to-treat analysis confirmed non-inferiority of home-based rehabilitation for 6MWD at end-rehabilitation and the confidence interval (CI) did not rule out superiority (mean difference favouring home group 18.6 m, 95% CI -3.3 to 40.7). At 12 months the CI did not exclude inferiority (-5.1 m, -29.2 to 18.9). Between-group differences for dyspnoea-related quality of life did not rule out superiority of home-based rehabilitation at programme completion (1.6 points, -0.3 to 3.5) and groups were equivalent at 12 months (0.05 points, -2.0 to 2.1). The per-protocol analysis showed the same pattern of findings. Neither group maintained postrehabilitation gains at 12 months. CONCLUSIONS: This home-based pulmonary rehabilitation model, delivered with minimal resources, produced short-term clinical outcomes that were equivalent to centre-based pulmonary rehabilitation. Neither model was effective in maintaining gains at 12 months. Home-based pulmonary rehabilitation could be considered for people with COPD who cannot access centre-based pulmonary rehabilitation. TRIAL REGISTRATION NUMBER: NCT01423227, clinicaltrials.gov.
dc.languageEnglish
dc.publisherBMJ PUBLISHING GROUP
dc.titleHome-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial
dc.typeJournal Article
dc.identifier.doi10.1136/thoraxjnl-2016-208514
melbourne.affiliation.departmentMedicine and Radiology
melbourne.affiliation.departmentMelbourne School of Population and Global Health
melbourne.source.titleThorax
melbourne.source.volume72
melbourne.source.issue1
melbourne.source.pages57-65
dc.rights.licenseCC BY-NC
melbourne.elementsid1107208
melbourne.contributor.authorMcDonald, Christine
melbourne.contributor.authorMahal, Ajay
dc.identifier.eissn1468-3296
melbourne.accessrightsOpen Access


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