Long-term effect of home-based pulmonary rehabilitation in severe asthma

Respir Med. 2019 Oct:157:36-41. doi: 10.1016/j.rmed.2019.08.015. Epub 2019 Aug 29.

Abstract

Introduction: Home-based pulmonary rehabilitation (PR) has demonstrated its effectiveness amongst patients with chronic obstructive pulmonary disease (COPD) but has never been investigated in severe asthma.

Methods: In a retrospective study, we included 28 patients with severe asthma (61.5 ± 16.2 years, FEV1: 51.4 ± 17.3%) and 164 matched COPD patients (64.3 ± 11.6 years, FEV1: 47.7 ± 15.5%) who had completed a home-based PR program and pursued at least 12 months of follow-up. The number of steps performed during a 6-min stepper test (6MST), the Hospital Anxiety and Depression (HAD) scores, and the Visual Simplified Respiratory Questionnaire score (VSRQ) were compared between baseline, the post-PR period (post-PR) and after 12 months of follow-up (M12) within each group. The evolution of the 6MST, HAD and VSRQ values between baseline, post-PR and M12 was compared between severe asthma and COPD patients.

Results: In the severe asthma group, the 6MST was higher post-PR (504 ± 150, p = 0.043) and at M12 (538 ± 163, p = 0.016) compared with baseline (450 ± 148). The VSRQ score was higher at M12 (39.0 ± 18.6, p = 0.049) but not post-PR (38.7 ± 15.8, p = 0.119) in comparison with baseline (32.2 ± 12.4). There was no difference in the HAD scores between baseline, post-PR and M12. PR outcome was not significantly different between severe asthma and COPD patients at short and long term (p > 0.05).

Conclusion: In severe asthma, home-based PR is associated with improved exercise tolerance and quality of life on a long-term basis but does not modify anxiety and depression.

Keywords: 6-Min stepper test; Anxiety; Chronic obstructive pulmonary disease; Depression; Exercise tolerance; Quality of life.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Asthma / physiopathology
  • Asthma / psychology
  • Asthma / rehabilitation*
  • Case-Control Studies
  • Depression / epidemiology
  • Depression / psychology
  • Exercise Therapy / methods*
  • Exercise Tolerance
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / psychology
  • Pulmonary Disease, Chronic Obstructive / rehabilitation*
  • Quality of Life
  • Respiratory Function Tests / methods
  • Retrospective Studies
  • Severity of Illness Index
  • Time
  • Treatment Outcome