Effect of Home Based Pulmonary Rehabilitation on Exacerbation and Hospital Admission in Severe COPD

Pulmonary Rehabilitation (PR) is a comprehensive intervention designed to improve not only exercise, education and behavioral changes, but also the physical and psychological state of individuals, based on detailed patient evaluation and subsequent patient-specific therapies in individuals with chronic respiratory disease. It is integrated into the lifelong care and management of the chronic respiratory patient. It requires an active collaboration between the patient, family, and the Pulmonary Rehabilitation team. Due to the complex nature of respiratory diseases, many disciplines should be involved in the maintenance of treatment.

Pulmonary rehabilitation is a useful treatment component in almost all chronic respiratory patients, especially COPD (Chronic obstructive pulmonary disease). There are studies showing that it reduces the number of attacks and the frequency of hospitalization even in COPD patients with frequent attacks. As pulmonary rehabilitation methods; It is possible to see that there are many types such as supervised exercise programs in the hospital, telephone monitoring or home programs.In-hospital supervised programs are time-consuming and costly applications. This situation causes an increase in the tendency towards applications without direct supervision and increases the need for studies on the effectiveness and benefits of these applications.

The use of home-type spirometers are practical devices that provide close monitoring of respiratory functions and enable the detection of disease symptoms in a short time. The use of these devices has increased especially during the pandemic period. In a study conducted with asthma patients, it was reported that early diagnosis and intervention is possible in cases with self-monitoring by mobile spirometry. In another study, in which e-monitoring of cases with duchenne muscular dystrophy (DMD) was performed with a spirometer device during the covid 19 pandemic, the importance of regular spirometric follow-ups of DMD cases as a part of their daily routine and making it a part of health care services was emphasized.

In our study, advanced stage COPD cases constitute the case group. The exacerbation and hospital admission rates are extremely high in these patients. There are also transfer problems to the hospital due to existing physical limitations. With the planned study, close follow-up of the patients with the help of home-type spirometry will be carried out over a 1-year period, and a pulmonary rehabilitation exercise program will be applied in this process. The effect of the applied follow-up and exercise program on disease exacerbation and hospital admission rates will be examined.

• Pulmonary Function Test (PFT) with home spirometry for FVC (Forced Vital Capacity) value [Срок оценки: Baseline to one year]
• Daily Saturation Monitoring [Срок оценки: Baseline to one year]
• Symptom scoring [Срок оценки: Baseline to one year]
• Peripheral muscle strength measurement [Срок оценки: Baseline to one year]
• 6 minutes walking test [Срок оценки: Baseline to one year]
• Modified medical Council Dyspnea score [Срок оценки: Baseline to one year]
• Determination of quality of life [Срок оценки: Baseline to one year]
• Psychological status assessment [Срок оценки: Baseline to one year]
• Cognitive status assessment [Срок оценки: Baseline to one year]
• Physical activity level [Срок оценки: Baseline to one year]
• Heart Rate Monitoring [Срок оценки: Baseline to one year]
• Pulmonary Function Test (PFT) with home spirometry for FEV1 (Forced Expiratory Volume First Second) value [Срок оценки: Baseline to one year]