Rethinking Pulmonary Rehabilitation (REPORT)
Chronic Obstructive Pulmonary Disease
About this trial
This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease
Eligibility Criteria
Inclusion Criteria: Indication for pulmonary rehabilitation according to Danish national guidelines Unable to access and participate in the conventional out-patient hospital- or community-based PR when offered during routine consultation A post-bronchodilator ratio FEV1/FVC <70% (confirmed physician diagnosis of COPD) A post-bronchodilator FEV1 <80% (degree of airway obstruction) corresponding to GOLD grade 2-4 (moderate to very severe) GOLD group B, C, D corresponding to severe respiratory symptoms and/or frequent acute exacerbations Able to stand up from a chair (height 44-46cm) and walk 10 meters independently (with or without a walking aid) Able to lift both arms to a horizontal level with a minimum of 1 kilogram's dumbbells in each hand Exclusion Criteria: Participation in conventional PR in the past 24 months Cognitive impairment - unable to follow instructions Impaired hearing or vision - unable to see or hear instruction from a tablet Unable to understand and speak Danish Comorbidities where the exercise content is contraindicated (e.g. treatment for diabetic foot ulcer, active cancer treatment, life expectancy <12-months)
Sites / Locations
- Copenhagen University Hospital AmagerRecruiting
- Copenhagen University Hospital Bispebjerg-FrederiksbergRecruiting
- Copenhagen University Hospital Herlve-GentofteRecruiting
- Copenhagen University Hospital GlostrupRecruiting
- Copenhagen University Hospital NordsjaellandRecruiting
- Copenhagen University Hospital HvidovreRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Active Comparator
pulmonary tele-rehabilitation (PTR)
home-based pulmonary rehabilitation (HPR)
Control
Recieve supervised PTR 2/weekly, session duration of 60 min; 35 min of exercise and 25min of patient education for 10-weeks (primary endpoint). Delivered from Hvidovre/Bispebjerg Hospital to groups of 4-6 patients who exercise at home and communicate via tablet-camera. After 10-weeks of PTR, participants are offered once weekly PTR for 60minuttes in groups of 4-8 patients throughout a 65-week maintenance period (secondary endpoint 75-weeks from baseline).
HPR is an individual self-initiated home-based PR program. Patient goal is to achieve at least 20 min of self-initiated muscle-endurance based exercise 3days/weekly for 10-weeks (primary endpoint). The first session is a home visit by an experienced respiratory physiotherapist and with focus on establishment of exercise goals, formal exercise prescription and education. The home visit is followed by 1/weekly session for 10-weeks.The sessions is delivered from Hvidovre/Bispebjerg Hospital via tablet-camera or telephone call. After 10-weeks of HPR, participants are offered once weekly PTR for 60min in groups of 4-8 patients throughout a 65-week maintenance period (secondary endpoint 75-weeks from baseline).
Control group will receive usual care; medication, scheduled follow-up visit and possible phone contact with GP or the outpatient respiratory department. Except for assessment visits 10-, 35-, and 75-weeks from baseline no intervention is offered.