• Anja Frei, Thomas Radtke, Dalla LanaKabaKEpidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland., Patrick Brun, Thomas Sigrist, Marc Spielmanns, Swantje Beyer, Thomas F Riegler, Gilbert Büsching, Sabine Spielmanns, Ramona Kunz, Tamara Cerini, Julia Braun, Yuki Tomonaga, Miquel Serra-Burriel, Ashley Polhemus, and Milo A Puhan.
• Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland. Electronic address: anja.frei@uzh.ch.
• Chest. 2022 Dec 1; 162 (6): 127712861277-1286.

BackgroundMost patients with COPD do not maintain exercise training after pulmonary rehabilitation (PR).Research QuestionDoes a 12-month home-based, minimal-equipment strength training program after PR have an effect on dyspnea, exercise capacity, and patient-reported outcomes in patients with COPD?Study Design And MethodsIn a parallel-arm multicenter study across four Swiss PR clinics, patients with COPD were allocated randomly (1:1 ratio) into an intervention group (IG; home-based strength training program) or control group (CG; usual care). The primary outcome was change in Chronic Respiratory Questionnaire (CRQ) dyspnea scale score from baseline to 12 months. Secondary outcomes were change in exercise capacity (1-min sit-to-stand-test [1MSTST], 6-min walk test [6MWT]), health-related quality of life, exacerbations, and symptoms. We assessed the IG's experience by interviews at study end. Main analyses were based on the intention-to-treat approach, and adjusted linear regression models were used.ResultsOne hundred twenty-three patients with COPD (IG, n = 61; CG, n = 62) were randomized, 61 of whom were women and whose mean ± SD age was 66.8 ± 8.1 years and mean ± SD FEV1 was 39.3 ± 15.3% predicted. One hundred four participants completed 12 months of follow-up (IG, n= 53; CG, n= 51). Of the 53 IG participants, 37 participants (70%) conducted the training until study end. We found no difference in change in CRQ dyspnea scale score over 12 months (adjusted mean difference, 0.28; 95% CI, -0.23 to 0.80; P = .27). We found moderate evidence for a difference in 1MSTST repetitions favoring the IG (adjusted mean difference, 2.6; 95% CI, 0.22-5.03; P = .033), but no evidence for an effect in other outcomes. Seventy-nine percent of the IG reported positive effects that they attributed to the training.InterpretationThe home exercise program had no effect on dyspnea, but improved 1MSTST performance and patient-perceived fitness. The supported program was well accepted by patients with COPD and may facilitate continued exercise training at home.Trial RegistryClinicalTrials.gov; No.: NCT03461887; URL: www.Clinicaltrialsgov.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

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