Pulmonary rehabilitation can be equally effective in hospital and home settings.

Question: Is pulmonary rehabilitation with the exercise component performed at home as effective at reducing dyspnoea as outpatient pulmonary rehabilitation? Design: Randomised, controlled trial with concealed allocation. Setting: Ten centres in Canada. Participants: Adults with stable chronic obstructive pulmonary disease (COPD), aged at least 40 years, with an FEV1 less than 70% of the predicted value, an FEV1/FVC ratio of less than 0.70, and a Medical Research Council dyspnoea score of 2 or more. Previous pulmonary rehabilitation was an exclusion criterion. Randomisation of 252 participants allotted 126 to each group. Interventions: Both groups received the same eight educational lectures over 4 weeks as hospital outpatients. The outpatient group then commenced combined aerobic and strength training on an outpatient basis with supervision, attending three sessions per week for 8 weeks. Each session consisted of cycle ergometry for 30 minutes at 80% of peak work capacity and progressive resistance exercises for 30 minutes. Supplemental oxygen was provided as appropriate. The other group trained at home, also for three sessions per week over the same 8 weeks. The first session was supervised, Pulmonary rehabilitation can be equally effective in hospital and home settings