PT - JOURNAL ARTICLE AU - Seymour, John M AU - Moore, Lauren AU - Jolley, Caroline J AU - Ward, Katie AU - Creasey, Jackie AU - Steier, Joerg S AU - Yung, Bernard AU - Man, William D-C AU - Hart, Nicholas AU - Polkey, Michael I AU - Moxham, John TI - Outpatient pulmonary rehabilitation following acute exacerbations of COPD AID - 10.1136/thx.2009.124164 DP - 2010 May 01 TA - Thorax PG - 423--428 VI - 65 IP - 5 4099 - http://thorax.bmj.com/content/65/5/423.short 4100 - http://thorax.bmj.com/content/65/5/423.full SO - Thorax2010 May 01; 65 AB - Background Exacerbations of chronic obstructive pulmonary disease (COPD) are characterised by increased dyspnoea, reduced quality of life and muscle weakness. Re-exacerbation and hospital admission are common. Pulmonary rehabilitation (PR) administered after hospital admission for an exacerbation can improve quality of life and exercise capacity.Objective To determine whether outpatient post-exacerbation PR (PEPR) could reduce subsequent hospital admission episodes.Methods Patients admitted to hospital for an exacerbation of COPD were randomised to receive either usual follow-up care (UC) or PEPR after discharge. Hospital admission and emergency department attendances for COPD exacerbations were recorded over a 3-month period and analysed on an intention-to-treat basis. Secondary outcomes included exercise capacity and quadriceps strength.Results 60 patients underwent concealed randomisation at the time of their hospital discharge (UC: n=30, mean (SD) age 65 (10) years, forced expiratory volume in 1 s (FEV1) 52 (22)% predicted; PEPR: n=30, 67(10) years, 52 (20)% predicted). The proportion of patients re-admitted to hospital with an exacerbation was 33% in the UC group compared with 7% in those receiving PEPR (OR 0.15, 95% CI 0.03 to 0.72, p=0.02). The proportion of patients that experienced an exacerbation resulting in an unplanned hospital attendance (either admission or review and discharge from the emergency department) was 57% in the UC group and 27% in those receiving PEPR (OR 0.28, 95% CI 0.10 to 0.82, p=0.02).Conclusions Post-exacerbation rehabilitation in COPD can reduce re-exacerbation events that require admission or hospital attendance over a 3-month period.Clinical Trials Registration Number NCT00557115.