Home-based pulmonary rehabilitation and follow-up strategies in COPD patients: a systematic review

Title: Home-based pulmonary rehabilitation and follow-up strategies in COPD patients: a systematic review Introduction: Availability and accessibility to Pulmonary Rehabilitation (PR) programs continues to be lower than the needs of COPD patients. PR programs have positive effects in COPD’s patients condition that decrease over time. It is essential to develop intervention strategies that help them to maintain PR effects at home. Methods: A Systematic Literature Review based on Cochrane model. We used the PICOT method with the main starting question: What are the components of a Home-Based PR program and the maintenance strategies that should be considered in the care model of COPD patients, after an intensive PR program, in order to maintain the effects of this therapy?. Database search was conducted before September 13, 2018, in CINAHL; MEDLINE; EMBASE and Web of Science. Three independent reviewers assessed methodologic quality and reviewed the studies. Results: A total of 1531 articles were identified, which were consecutively excluded, according to the defined inclusion and exclusion criteria, and a final sample of 5 articles were obtained (all of them randomized controlled trials). Conclusions: In the endurance training, the scientific evidence take special emphasis on walking and use of the portable cycle ergometer. In muscle strengthening training, it emphasizes weight training, exercises against gravity, up and down stairs and also the sit to stand exercise. The maintenance strategies were the use of: diary; pedometer; guidance guides and telephone contact.