P53 PULMONARY REHABILITATION USING THE SPACE (A SELF-MANAGEMENT PROGRAMME OF ACTIVITY, COPING AND EDUCATION) MANUAL AT HOME: A RANDOMISED CONTROLLED TRIAL

¹K. Wagg, ²E. Wilcock, ¹J. Williams, ¹L. Sewell, ¹M. Steiner, ¹M. Morgan, ²S. Singh. ¹University Hospitals Leicester, Leicester, UK, ²Coventry University, Coventry, UK

Pulmonary rehabilitation is an established intervention for patients with chronic obstructive pulmonary disease (COPD), however capacity across the UK is low. The traditional model of rehabilitation is 6–8 weeks of supervised exercise and education. We have developed a self-management manual for COPD (SPACE: A Self-management Programme of Activity, Coping and Education). If a self-managed pulmonary rehabilitation programme is effective, alternative forms of pulmonary rehabilitation may become more widely available. The aim of this study is to determine the effectiveness of a self-management programme against conventional rehabilitation.

Participants with COPD were recruited following a standard pulmonary rehabilitation assessment and randomly allocated to either a 7-week conventional rehabilitation course or self-managed rehabilitation using the SPACE manual. The primary outcome measure was peak exercise performance (Incremental Shuttle Walking Test (ISWT)) measured at initial assessment and 7 weeks. Other outcome measures were Endurance Shuttle Walk Test (ESWT), Self-Reported Chronic Respiratory Questionnaire (CRQ-SR) Dyspnoea Domain and the Medical Research Council Dyspnoea Scale (MRC). 62 patients were recruited and allocated to conventional rehabilitation (n = 29; mean (SD) age 67.93 (7.47); forced expiratory volume in 1 s (FEV₁) 1.38 (0.52); body mass index (BMI) 26.27 (5.91); 18 men) or self-management (n = 33; mean (SD) age 66.75 (8.00); FEV₁ 1.16 (0.36); BMI 26.77 (5.76); 2 men). Patients were re-assessed at 7 weeks and paired t tests were performed for all outcome measures.

There were statistically significant improvements for both conventional rehabilitation and self-managed rehabilitation in ISWT with mean changes of 54.48±89.06 and 40.30±70.02, respectively. There were also statistically significant improvements for ESWT, CRQ-SR Dyspnoea and MRC in both groups; mean changes in conventional rehabilitation being 500.62, …