Home exercise program versus supervised pulmonary rehabilitation program in preparation for lung volume reduction surgery

Purpose: To evaluate benefits of preop home exercise program (HEP) for group of patients (pts.) accepted for lung volume reduction surgery (LVRS) compared to supervised pulmonary rehabilitation program (SPRP) in matched group of pts. Methods: Group of pts preparing for LVRS received HEP due to lack of local, hospital SPRP. The home exercise group (cases) compared with similar group of pts (controls) who underwent SPRP. Two controls (ctrl) selected for each case based on sex, age , 6 minute walk (6MW) distance, and FEV₁. Cases-6 pts (2 males, 4 females), mean age 62, mean FEV₁ .770 L. Ctrl-12 pts (4 males, 8 females) mean age 62, mean FEV₁ .672 L. Both groups exercised for minimum of 6 weeks prior to LVRS. Cases received exercise program that included treadmill for 30 minutes 5-7 days/week. Home treadmills had DC motor with at least 1 HP and speeds of < 1 mph. Oximeters rented/purchased by pts. O₂ requirements, target heart rate range and speed/distance goals were provided. Using O2, SaO₂ was 88% or > at rest / with exercise. Pts sent exercise logs to LVRS center. Ctrl group underwent outpatient SPRP at local hospital; exercise protocol was similar to case group. Results: Eval Preop 6 mon post LVRS Case Ctrl Case Ctrl Case Ctrl 6 MW ft 1083 1048 1383 1244 1597 1426 Conclusions: Given instruction, pts can carry out HEP with similar results pre and post LVRS as control (SPRP) group. Clinical Implications: While we strongly favor SPRP for these pts, a HEP is feasible in preparation for LVRS.