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Efficacy of pulmonary rehabilitation in patients with moderate chronic obstructive pulmonary disease: a randomized controlled trial

Miguel Román1*, Concepción Larraz2, Amalia Gómez3, Joana Ripoll4, Isabel Mir5, Eduardo Z Miranda6, Ana Macho7, Vicenç Thomas8 and Magdalena Esteva4

Author Affiliations

1 Primary Care Majorca Department, Son Pisà Primary Health Centre, C/ Vicenç Joan Perello Ribes, 65, Palma de Mallorca, Baleares, Spain

2 Primary Care Majorca Department, Escuela Graduada Primary Health Centre, Palma de Mallorca, Baleares, Spain

3 Primary Care Majorca Department, Coll d´en Rabassa Primary Health Centre, Palma de Mallorca, Baleares, Spain

4 Primary Care Majorca Department, Unit of Research, Palma de Mallorca, Baleares, Spain

5 Primary Care Majorca Department, Hospital Son Llàtzer, Unit of Pneumology, Palma de Mallorca, Baleares, Spain

6 Primary Care Majorca, Emili Darder Primary Health Centre, Palma de Mallorca, Baleares, Spain

7 Primary Care Madrid Department, Aspes Primary Health Centre, Madrid, Spain

8 Primary Care Majorca, Camp Redó Primary Health Centre, Palma de Mallorca, Baleares, Spain

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BMC Family Practice 2013, 14:21  doi:10.1186/1471-2296-14-21

Published: 11 February 2013



Pulmonary Rehabilitation for moderate Chronic Obstructive Pulmonary Disease in primary care could improve patients’ quality of life.


This study aimed to assess the efficacy of a 3-month Pulmonary Rehabilitation (PR) program with a further 9 months of maintenance (RHBM group) compared with both PR for 3 months without further maintenance (RHB group) and usual care in improving the quality of life of patients with moderate COPD.

We conducted a parallel-group, randomized clinical trial in Majorca primary health care in which 97 patients with moderate COPD were assigned to the 3 groups. Health outcomes were quality of life, exercise capacity, pulmonary function and exacerbations.


We found statistically and clinically significant differences in the three groups at 3 months in the emotion dimension (0.53; 95%CI0.06-1.01) in the usual care group, (0.72; 95%CI0.26-1.18) the RHB group (0.87; 95%CI 0.44-1.30) and the RHBM group as well as in fatigue (0.47; 95%CI 0.17-0.78) in the RHBM group. After 1 year, these differences favored the long-term rehabilitation group in the domains of fatigue (0.56; 95%CI 0.22-0.91), mastery (0.79; 95%CI 0.03-1.55) and emotion (0.75; 95%CI 0.17-1.33). Between-group analysis only showed statistically and clinically significant differences between the RHB group and control group in the dyspnea dimension (0.79 95%CI 0.05-1.52). No differences were found for exacerbations, pulmonary function or exercise capacity.


We found that patients with moderate COPD and low level of impairment did not show meaningful changes in QoL, exercise tolerance, pulmonary function or exacerbation after a one-year, community based rehabilitation program. However, long-term improvements in the emotional, fatigue and mastery dimensions (within intervention groups) were identified.

Trial registration


Chronic obstructive pulmonary disease; Pulmonary rehabilitation; Quality of life; Clinical trial; Primary care