Bishop Joshua A, Spencer Lissa M, Dwyer Tiffany J, McKeough Zoe J, McAnulty Amanda, Leung Regina, Alison Jennifer A
Sydney School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.
Department of Physiotherapy, Balmain Hospital, Balmain, New South Wales, Australia.
Respirology. 2025 Jan;30(1):41-50. doi: 10.1111/resp.14820. Epub 2024 Sep 3.
There is no strong evidence on the optimal duration of pulmonary rehabilitation (PR) programmes. The aim of the study was to determine whether an 8-week PR programme was equivalent to a 12-week PR programme in improving endurance exercise capacity in people with chronic obstructive pulmonary disease (COPD).
Participants with COPD were randomized to either an 8-week (8-wk Group) or 12-week (12-wk Group), twice weekly, supervised PR programme consisting of endurance and strength training and individualized self-management education. Between group comparisons were made at completion of each programme (i.e., week 8 or week 12), for both programmes at week 12, and at 6-12-month follow-up. The primary outcome was endurance exercise capacity measured by the endurance shuttle walk test (ESWT) with the minimally important difference of 186 s set as the equivalence limit.
Sixty-six participants [mean (SD); age 69 (7) years, FEV 48 (17) %predicted] were randomized (33 per group). Between-group comparisons demonstrated that the ESWT time was equivalent for the 12-wk Group compared to the 8-wk Group at programme completion [mean (95% CI)] [71 s (-61 to 203)], week 12 [70 s (-68 to 208)], and 6-12-month follow-up [93 s (-52 to 239)], though superiority of the 12-wk Group could not be ruled out at each time point.
Equivalence was shown between 8-and 12-week PR programmes for endurance exercise capacity, but superiority could not be ruled out for the 12-wk Group. Decisions about programme duration may depend on local waitlist times, healthcare budgets and patient preference.
目前尚无有力证据表明肺康复（PR）计划的最佳时长。本研究旨在确定为期8周的PR计划与为期12周的PR计划在改善慢性阻塞性肺疾病（COPD）患者耐力运动能力方面是否等效。
COPD患者被随机分为8周组（8周组）或12周组（12周组），每周两次，接受由耐力和力量训练以及个性化自我管理教育组成的监督PR计划。在每个计划结束时（即第8周或第12周）、两个计划在第12周时以及6 - 12个月随访时进行组间比较。主要结局是通过耐力穿梭步行试验（ESWT）测量的耐力运动能力，将最小重要差异设定为186秒作为等效性界限。
66名参与者[平均（标准差）；年龄69（7）岁，第1秒用力呼气容积（FEV）为预计值的48（17）%]被随机分组（每组33人）。组间比较表明，在计划完成时[平均（95%可信区间）][71秒（-61至203）]、第12周[70秒（-68至208）]以及6 - 12个月随访时[93秒（-52至239）]，12周组与8周组的ESWT时间相当，不过在每个时间点都不能排除12周组的优越性。
8周和12周的PR计划在耐力运动能力方面显示出等效性，但不能排除12周组的优越性。关于计划时长决定可能取决于当地的等待名单时间、医疗保健预算和患者偏好。
