Effectiveness of home-based pulmonary rehabilitation: systematic review and meta-analysis

Nazim Uzzaman, Dhiraj Agarwal, Soo Chin Chan, Julia Patrick Engkasan, Monsur Habib, Nik Sherina Hanafi, Tracy Jackson, Paul Jebaraj, Ee Ming Khoo, Fatim Tahirah Mirza Mohd Tahir , Hilary Pinnock, Ranita Hisham Shunmugam, Roberto Rabinovich*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

INTRODUCTION: Despite proven effectiveness for people with chronic respiratory diseases, practical barriers to attending centre-based pulmonary rehabilitation (centre-PR) limit accessibility. We aimed to review the clinical effectiveness, components and completion rates of home-based pulmonary rehabilitation (home-PR) compared to centre-PR or usual care. METHODS AND ANALYSIS: Using Cochrane methodology, we searched (January 1990 to August 2021) six electronic databases using a PICOS (population, intervention, comparison, outcome, study type) search strategy, assessed Cochrane risk of bias, performed meta-analysis and narrative synthesis to answer our objectives and used the Grading of Recommendations, Assessment, Development and Evaluations framework to rate certainty of evidence. RESULTS: We identified 16 studies (1800 COPD patients; 11 countries). The effects of home-PR on exercise capacity and/or health-related quality of life (HRQoL) were compared to either centre-PR (n=7) or usual care (n=8); one study used both comparators. Compared to usual care, home-PR significantly improved exercise capacity (standardised mean difference (SMD) 0.88, 95% CI 0.32-1.44; p=0.002) and HRQoL (SMD -0.62, 95% CI -0.88--0.36; p<0.001). Compared to centre-PR, home-PR showed no significant difference in exercise capacity (SMD -0.10, 95% CI -0.25-0.05; p=0.21) or HRQoL (SMD 0.01, 95% CI -0.15-0.17; p=0.87). CONCLUSION: Home-PR is as effective as centre-PR in improving functional exercise capacity and quality of life compared to usual care, and is an option to enable access to pulmonary rehabilitation.

Original languageEnglish
Article number220076
Number of pages20
JournalEuropean Respiratory Review
Issue number165
Publication statusPublished - 20 Sept 2022

Keywords / Materials (for Non-textual outputs)

  • Exercise
  • Exercise Tolerance
  • Humans
  • Pulmonary Disease, Chronic Obstructive/diagnosis
  • Quality of Life


Dive into the research topics of 'Effectiveness of home-based pulmonary rehabilitation: systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this