A key component in the management of chronic obstructive pulmonary disease (COPD) patients is pulmonary rehabilitation (PR), the corner stone of which is exercise training. A study by Ghanem and associates evaluated the effect of a two-months, home-based PR program with outpatient supervision every two weeks, on exercise tolerance and health-related quality of life (HRQL), using Arabic-translated standardized generic and specific questionnaires in COPD patients recently recovered from acute exacerbation. A total of 39 COPD patients were recruited into a randomized trial. They had recovered from acute exacerbation and were randomly allocated either a two-month home-based PR program, in addition to standard medical therapy, or standard medical therapy alone in the period between July 2008 and March 2009. Outcome measures included pulmonary function tests (PFTs), six-minute walk distance (6-MWD) test, Arabic-translated chronic respiratory disease questionnaire-self administered standardized format (CRQ-SAS), and quality of life scale Short Form (SF-36). Comparisons were made between 25 patients with moderate to severe COPD who underwent a two-month PR program (group 1) and 14 COPD patients who did not (group 2). Group 1 showed significant improvement in the 6-MWD, and HRQL scores at two months compared with the usual care patients in group 2 (P less than 0.05). Improvement in both CRQ-SAS and SF-36 scores were statistically significant and comparable in group 1.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that the supervised, post discharge, two-month home-based PR program is an effective non pharmacological intervention in the management of stable patients with COPD. The 6-MWD is a simple, inexpensive and safe test to assess physical and functional capabilities among COPD patients. HRQL can be measured in patients with COPD either by disease-specific tools that have been specifically designed for use in patients with respiratory system disorders or by generic HRQL tools that can be used across populations with a variety of medical conditions. The Arabic-translated CRQ-SAS is a new tool for assessment of Arabic-speaking patients with chronic respiratory diseases.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: It is good to see such studies emerging from developing countries. Investigators not only designed the study, but translated outcome measures so they could be used in Eqypt. Their efforts must be applauded.

M Ghanem et al. Home-based pulmonary rehabilitation program: Effect on exercise tolerance and quality of life in chronic obstructive pulmonary disease patients. Annals of Thoracic Medicine, 2010;5:18-25.