Reabilitação pulmonar domiciliar para indivíduos com doença pulmonar obstrutiva crônica: um estudo de viabilidade

Abstract

Introduction: Pulmonary Rehabilitation (RP) is a strategy that associates therapeutic exercises, health education and behavior change. Despite the benefits attached to this proposal, the adherence to PR is low due to certain barriers, such as a displacement to the rehabilitation center and travel expenses. In this context, home-based PR appears as an alternative to overcome these barriers and has been equally efficient and safe when compared to the conventional outpatient strategy. The objective of the study is to describe a pilot research protocol for an unsupervised PR program in individuals with COPD followed at a Pulmonology outpatient clinic in Fortaleza-CE. Methods: In this feasibility research, 42 individuals will be recruited in outpatient clinic at a university hospital. Subjects will be approached in the waiting room and upon agreeing to participate, a structured preliminary assessment will be performed followed by a physical evaluation aimed to assess functional capacity, muscular strength and aerobic performance. The participant will also receive information about this health condition and about the individualized training that will follow at his home during eight weeks. An exercise plan and diary will be delivered and the safety criteria for the training sessions will be carefully explained. The participant will receive weekly motivational telephone calls to follow their physical evolution and will be reassessed at the end of the training. In the data analysis, the distribution of normality will be performed by Shapiro-Wilk test. The analysis of response to the intervention will be analyzed through T test of paired data or by Wilcoxon paired test. A significant value of p <0.05 will be considered. Discussion: The relevance of pilot studies is well established in the literature especially as justification and guidance for a successful randomized controlled trial. Remote PR has a flexible and motivational property, but with also some disadvantages attached such as monotony because of lack of variety in training as well as physical disability already installed in the individual. With the implementation of this program it is not intended that it be superior to supervised PR but that it is equivalent in terms of achievable benefits.