PT  - JOURNAL ARTICLE
AU  - Suhani Patel
AU  - Melanie D Palmer
AU  - Claire Marie Nolan
AU  - Ruth Emily Barker
AU  - Jessica Anne Walsh
AU  - Stephanie C Wynne
AU  - Sarah Elizabeth Jones
AU  - Harriet Shannon
AU  - Nicholas S Hopkinson
AU  - Samantha Swee Chin Kon
AU  - Wei Gao
AU  - Matthew Maddocks
AU  - William D-C Man
TI  - Supervised pulmonary rehabilitation using minimal or specialist exercise equipment in COPD: a propensity-matched analysis
AID  - 10.1136/thoraxjnl-2020-215281
DP  - 2021 Mar 01
TA  - Thorax
PG  - 264--271
VI  - 76
IP  - 3
4099  - http://thorax.bmj.com/content/76/3/264.short
4100  - http://thorax.bmj.com/content/76/3/264.full
SO  - Thorax2021 Mar 01; 76
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.