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@article{Patel:2021:10.1136/thoraxjnl-2020-215281,
author = {Patel, S and Palmer, MD and Nolan, CM and Barker, RE and Walsh, JA and Wynne, SC and Jones, SE and Shannon, H and Hopkinson, NS and Kon, SSC and Gao, W and Maddocks, M and Man, WD-C},
doi = {10.1136/thoraxjnl-2020-215281},
journal = {Thorax},
pages = {264--271},
title = {Supervised pulmonary rehabilitation using minimal or specialist exercise equipment in COPD: a propensity-matched analysis},
url = {http://dx.doi.org/10.1136/thoraxjnl-2020-215281},
volume = {76},
year = {2021}
}

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TY  - JOUR
AB  - BACKGROUND: Many trials supporting the benefits of pulmonary rehabilitation (PR) have used specialist exercise equipment, such as treadmills and cycle ergometers. However, access to specialist equipment may not be feasible in some settings. There is growing interest in delivering PR programmes with minimal, low-cost equipment, but uncertainty remains regarding their efficacy compared with programmes using specialist equipment. METHODS: Using propensity score matching, 318 consecutive patients with COPD undergoing supervised PR using minimal equipment (PR-min) were compared 1:1 with a control group of 318 patients with COPD who underwent supervised PR using specialist equipment (PR-gym). A non-inferiority analysis was performed for the primary outcome (incremental shuttle walk (ISW)) and secondary outcomes (Chronic Respiratory Disease Questionnaire (CRQ)-domain and total scores). RESULTS: Similar improvements in ISW and CRQ-domains were observed in PR-min and PR-gym groups (mean difference ISW: 3 m (95% CI -16 to 9); CRQ-total: 0.9 (95% CI -2.7 to 4.5)). The 95% CI between group differences for ISW and CRQ-total did not cross the predefined non-inferiority margins. However, completion rates were lower in PR-min compared with PR-gym (64% vs 73%; p=0.014). CONCLUSIONS: In patients with COPD, PR delivered using minimal equipment produces clinically significant benefits in exercise capacity and health-related quality of life that are non-inferior to rehabilitation delivered using specialist equipment. This study provides support for the provision of PR using minimal exercise equipment, particularly in areas where access to specialist exercise equipment is limited.
AU  - Patel,S
AU  - Palmer,MD
AU  - Nolan,CM
AU  - Barker,RE
AU  - Walsh,JA
AU  - Wynne,SC
AU  - Jones,SE
AU  - Shannon,H
AU  - Hopkinson,NS
AU  - Kon,SSC
AU  - Gao,W
AU  - Maddocks,M
AU  - Man,WD-C
DO  - 10.1136/thoraxjnl-2020-215281
EP  - 271
PY  - 2021///
SN  - 0040-6376
SP  - 264
TI  - Supervised pulmonary rehabilitation using minimal or specialist exercise equipment in COPD: a propensity-matched analysis
T2  - Thorax
UR  - http://dx.doi.org/10.1136/thoraxjnl-2020-215281
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33132208
UR  - https://thorax.bmj.com/content/76/3/264
UR  - http://hdl.handle.net/10044/1/84478
VL  - 76
ER  -

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