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1、Thorax2010;65:7-13doi:10.1136/thx.2009.118620·ChronicobstructivepulmonarydiseaseShort-andlong-termefficacyofacommunity-basedCOPDmanagementprogrammeinlessadvancedCOPD:arandomisedcontrolledtrial1.CRvanWetering1,2.MHoogendoorn2,3.SJMMol1,4.MPMHRutten-vanMölken2,5.AMSchols3+AuthorAffiliations1.1
2、DepartmentofRespiratoryMedicine,MáximaMedicalCentre,Veldhoven,TheNetherlands2.2instituteforMedicalTechnologyAssessment(iMTA),ErasmusMC,Rotterdam,TheNetherlands3.3DepartmentofRespiratoryMedicine,MaastrichtUniversityMedicalCentre,Maastricht,TheNetherlands1.CorrespondencetoDrASchols,Departmento
3、fRespiratoryMedicine,MaastrichtUniversityMedicalCentre,POBox5800,6202AZMaastricht,TheNetherlands;a.schols@pul.unimaas.nl·Received27April2009·Accepted4August2009·PublishedOnlineFirst23August2009 NextSectionAbstractBackground:TheeffectivenessofpulmonaryrehabilitationinadvancedCOPDiswellestabli
4、shed,butfewdataareavailableinlessadvanceddisease.Methods:Ina2yearrandomisedcontrolledtrial,199patientswithanaveragemoderateairflowobstructionbutimpairedexercisecapacity(mean(SD)forcedexpiratoryvolumein1s(FEV1)60(16)%,peakworkload(Wmax)<70%)wererandomisedtotheINTERdisciplinaryCOMmunity-basedC
5、OPDmanagementprogramme(INTERCOM)orusualcare.Interventionconsistedof4monthsmultidisciplinaryrehabilitationfollowedbya20-monthmaintenancephase.Outcomes(4,12,24months):health-relatedqualityoflife(StGeorge’sRespiratoryQuestionnaire(SGRQ)),exacerbationfrequency,MRCdyspnoeascore,cycleendurancetime
6、(CET),6-minutewalkingdistance(6MWD),skeletalmusclestrengthandpatients’andcaregivers’perceivedeffectiveness.Results:Between-groupcomparisonafter4monthsrevealedthefollowingmean(SE)significantdifferencesinfavourofINTERCOM:SGRQtotalscore4.06(1.39),p = 0.004;activityandimpactsubscores,p<0.01;MRCs
7、core0.33(0.13),p = 0.01;Wmax6.0(2.3)Watt,p = 0.02;CET221(104)s,p = 0.04;6MWD13(6)m,p = 0.02;handgripforce4.3(1.5)lb,p<0.01;andfat-freemassindex0.34(0.13)kg/m2,p = 0.01.Between-groupdifferencesover2yearswereasfollows:SGRQ2.60(1.3),p = 0.04;MRCscore0
