Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, McGill University Health Centre, Montreal, Quebec, Canada.
Curr Opin Pulm Med. 2010 Mar;16(2):134-43. doi: 10.1097/MCP.0b013e32833642f2.
Home-based pulmonary rehabilitation programs have been proposed as an alternative to hospital-based programs for patients with chronic obstructive pulmonary disease (COPD). We undertook a systematic review of randomized studies on home-based pulmonary rehabilitation in patients with COPD which report health-related quality of life and/or exercise capacity, in order to assess the benefits of this intervention.
From 888 identified references, 12 met the inclusion criteria. Overall, the methodological quality of the studies was average to poor. Eight studies compared home-based rehabilitation to standard care, three compared home-based rehabilitation to hospital-based programs and one included both comparisons. Most of the studies showed improvement in health-related quality of life (statistically and clinically significant) and exercise capacity following home-based rehabilitation as compared with standard care (no pulmonary rehabilitation). Studies that compared home-based pulmonary rehabilitation with hospital-based outpatient programs have not been able to show statistically and clinically significant differences for health-related quality of life and exercise capacity. Adverse events, usually mild, were reported in only two studies.
Self-monitored, home-based rehabilitation may be an alternative to outpatient rehabilitation. These findings can help expand the recognition, application and accessibility of pulmonary rehabilitation for patients with COPD.
家庭为基础的肺康复计划已被提议作为慢性阻塞性肺疾病（COPD）患者替代住院为基础的计划。我们对 COPD 患者的家庭为基础的肺康复的随机研究进行了系统评价，这些研究报告了健康相关的生活质量和/或运动能力，以评估这种干预的益处。
从 888 篇确定的参考文献中，有 12 篇符合纳入标准。总体而言，研究的方法学质量为中等至较差。8 项研究将家庭为基础的康复与标准护理进行了比较，3 项研究将家庭为基础的康复与住院为基础的方案进行了比较，1 项研究同时包括了这两种比较。大多数研究表明，与标准护理（无肺康复）相比，家庭为基础的康复后健康相关的生活质量（统计学和临床意义上）和运动能力都有所改善。与住院门诊计划相比，家庭为基础的肺康复研究未能显示健康相关的生活质量和运动能力的统计学和临床意义上的差异。只有两项研究报告了不良反应，通常为轻度。
自我监测的、家庭为基础的康复可能是门诊康复的替代方案。这些发现可以帮助扩大对 COPD 患者肺康复的认识、应用和可及性。
Zotero 插件