# Pulmonary rehabilitation under supervision of health-professional at institute versus conventional exercise-based pulmonary rehabilitation at home in COPD patients: A longitudinal cohort study

## TL;DR

Institute-based pulmonary rehabilitation with professional supervision improves COPD outcomes more than home-based exercise programs in China.

## Contribution

Demonstrates the superior efficacy of supervised institute-based pulmonary rehabilitation over home-based methods for COPD patients in China.

## Key findings

- Institute-based rehabilitation improved walking test results and reduced BODE index scores and exacerbations after 6 months.
- Patients in the institute cohort had significantly better outcomes compared to home-based and no-rehabilitation groups.
- Chinese COPD patients face higher risks of undertreatment without proper rehabilitation.

## Abstract

•Guidelines recommended pulmonary rehabilitation in COPD.•Self-driven pulmonary rehabilitation is an undertreatment for COPD patients in China.•Chinese patients with COPD have worse clinical conditions.•Treatment with pulmonary rehabilitation at institutes improves clinical outcomes.•Chinese COPD patients are required to be treated as per proper guidelines.

Guidelines recommended pulmonary rehabilitation in COPD.

Self-driven pulmonary rehabilitation is an undertreatment for COPD patients in China.

Chinese patients with COPD have worse clinical conditions.

Treatment with pulmonary rehabilitation at institutes improves clinical outcomes.

Chinese COPD patients are required to be treated as per proper guidelines.

To evaluate the efficacy and safety of pulmonary rehabilitation under the supervision of health professionals at the institute versus conventional exercise-based pulmonary rehabilitation at home in Chronic Obstructive Pulmonary Disease (COPD) patients.

Patients of COPD received pulmonary rehabilitation under the supervision of a professional at the institute (PI cohort, n = 115) or self-driven traditional Chinese methods-based pulmonary rehabilitation at home (CE cohort, n = 127) or did not receive any type of pulmonary rehabilitation (ME cohort, n = 155). All patients received inhaled pharmacological treatment for COPD.

Before commencing inhaled pharmacological treatment with or without pulmonary rehabilitation (BT) COPD patients had 5 (5–4) / patient BODE (body-mass index, airflow obstruction, dyspnea, and exercise capacity) index score and 12 (13–12) / patient exacerbations (in 6-months) reported. After 6 months of inhaled pharmacological treatment for COPD with or without pulmonary rehabilitation (AT), a six-minute walking test was improved and the BODE index score and exacerbations during 6 months were decreased for patients of the PI cohort as compared to BT conditions and compared to those of the CE and ME cohorts in AT conditions (p < 0.05 for all). Patients of PI, CE, and ME cohorts had the risk of under treatment for <0.01 BODE index score, <1.32 BODE index score, and <3.14 BODE index score, respectively.

Chinese patients with COPD have worse clinical conditions. After 6 months of inhaled pharmacological treatment for COPD with pulmonary rehabilitations at institutes improves the conditions of COPD patients.