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RationalePulmonary rehabilitation (PR) is an effective, key standard treatment for people with COPD. Nevertheless, low participant uptake, insufficient attendance and high drop-out rates are reported. Investigation is warranted of the benefits achieved through alternative approaches, such as pulmonary tele-rehabilitation (PTR).ObjectiveTo investigate whether PTR is superior to conventional PR on 6 min walk distance (6MWD) and secondarily on respiratory symptoms, quality of life, physical activity and lower limb muscle function in patients with COPD and FEV1 MethodsIn this single-blinded, multicentre, superiority randomised controlled trial, patients were assigned 1:1 to 10 weeks of groups-based PTR (60 min, three times weekly) or conventional PR (90 min, two times weekly). Assessments were performed by blinded assessors at baseline, end of intervention and at 22 weeks’ follow-up from baseline. The primary analysis was based on the intention-to-treat principle.Measurements and main resultsThe primary outcome was change in 6MWD from baseline to 10 weeks; 134 participants (74 females, mean±SD age 68±9 years, FEV1 33%±9% predicted, 6MWD 327±103 metres) were included and randomised. The analysis showed no between-group differences for changes in 6MWD after intervention (9.2 metres (95% CI: −6.6 to 24.9)) or at 22 weeks’ follow-up (−5.3 metres (95% CI: −28.9 to 18.3)). More participants completed the PTR intervention (n=57) than conventional PR (n=43) (χ2 test pConclusionPTR was not superior to conventional PR on the 6MWD and we found no differences between groups. As more participants completed PTR, supervised PTR would be relevant to compare with conventional PR in a non-inferiority design.Trial registration numberClinicalTrials.gov (NCT02667171), 28 January 2016.

Between March 2016 and October 2017, we randomised 134 patients with severe COPD from 8 hospitals in the Capital Region of Denmark to participate in either standardised, outpatient pulmonary rehabilitation (control group) or on-line, supervised and home-based tele-rehabilitation (intervention group). We found no difference between the groups in the primary outcome: six minutes walking distance (6MWD) after completion of the programme. The current study presents results from the 12-month follow-up with assessment of the 6MWD and analyses of hospitalisation and mortality. There were no significant differences between or within the groups in the 6MWD one year after completion of the programme.

The aim of this study was to examine the value of the i-BODE index to predict hospital admission and to confirm its usefulness to predict mortality in a Danish population. The incremental shuttle walking test (ISWT) is widely used in the UK and Europe and previous work has examined the replacement of the 6MWT with the ISWT within the BODE index for predicting the prognosis of COPD (i-BODE). The 674 patients included in the analysis participated in a 7-week pulmonary rehabilitation program from 2002 to 2011. The National Health Services Central Register ascertained vital status and provided information on all hospital admissions. The mean follow-up period was 66 months (range 11-118 months). Cox proportional hazards model was used to identify factors that significantly predicted mortality and time to first hospital admission. The i-BODE index as well as body mass index, MRC dyspnea grade, and exercise capacity (ISWT) were significantly associated with all-cause mortality. The adjusted hazard ratio for death per one point increase in the i-BODE score was 1.28 (95% confidence interval 1.20 to 1.37). The i-BODE index was also a significant predictor of hospitalization, both for all causes and COPD exacerbation. Patients in the highest i-BODE quartile had a median time to first hospitalization of 17 months compared to 51 months for patients in the lowest quartile. The i-BODE index is a significant predictor of hospital admission and thus health care utilization, and also mortality.

The aim of this study was to compare the COPD specific health-related quality of life (HR-QoL) instruments, the St George's Respiratory Questionnaire (SGRQ), COPD Assessment Test (CAT), and COPD Clinical Questionnaire (CCQ), in terms of feasibility and correlations in COPD patients participating in pulmonary rehabilitation (PR).Ninety consecutive patients with mainly severe COPD who participated in a 7-week PR programme were assessed with CAT, CCQ, SGRQ. In addition to evaluating the scores obtained by the questionnaires we also assessed the need of help and the time needed to complete the questionnaires.Patients had mean FEV(1) = 38.7% of predicted value and poor quality of life (mean SGRQ total score 51.1, CAT 1.81, and CCQ 26.5 units). There were good correlations between the overall scores for the three HR-QoL instruments: CAT versus CCQ, r = 0.77; CAT versus SGRQ, r = 0.73; and CCQ versus SGRQ, r = 0.75 (p0.001 for all correlations). The average time to complete the questionnaires was 578 seconds for SGRQ, 107 seconds for CAT, and 134 seconds for CCQ. The need for assistance while answering the questionnaire was 86.5% for SGRQ, 53.9% for CAT, and 36.0% for CCQ.we observed a good correlation between the SGRQ, CCQ and CAT in this group of patients with severe COPD undergoing pulmonary rehabilitation. We found that CAT and CCQ have the advantage of being easier and faster to complete than the SGRQ. The need for help with the completion of the questionnaires was especially seen in patients with low education level.

Aim: To study the long-term benefits of ambulatory oxygen (AO) in combination with pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease (COPD) patients experiencing exertional desaturation. Patients and methods: Normoxaemic COPD who participated in outpatient PR and desaturated >4% and

SummaryBackgroundThe effect of pulmonary rehabilitation on EuroQol in COPD patients has not been investigated previously.Methods/materialsTwo hundred and twenty nine consecutive COPD patients who had completed a 7-week pulmonary rehabilitation programme were assessed with EuroQol five-dimension questionnaire (EQ-5D), endurance shuttle walk test (ESWT), and the St George's Respiratory Questionnaire (SGRQ) before and after the programme, and at the 3-month follow-up visit.ResultsTwo hundred and two (88.4%) patients had FEV1