Effect of Home-Based Pulmonary Rehabilitation Management on Bone Mineral Density and Function for Stable Chronic Obstructive Pulmonary Disease Patients With Osteoporosis: A Randomized Controlled Trial.

PURPOSE: This study aimed to examine the effect of home-based pulmonary rehabilitation (PR) on bone mineral density (BMD), lung function, dyspnea, and walking ability for stable Chronic Obstructive Pulmonary Disease (COPD) patients with OP (osteoporosis).

METHODS

The required sample size was 27 per group, adjusted to 32 per group to account for a 15% dropout rate, ensuring 90% power. This is a 6-month randomized, single-blind, controlled trial. COPD patients with OP were randomly divided into the home-based PR and control groups. Patients in the control group received the program of health education and drug treatment. Patients in the home-based PR group received additional home-based PR programs. The primary outcome was the bone mineral density (BMD) at the lumbar spine. The secondary outcomes included BMD at the femoral neck, lung function (FEV1% and FEV1/FVC), the modified Medical Research Council (mMRC), COPD assessment test (CAT), Borg dyspnea scale (Borg), and Six-minute walk distance test (6MWT). All outcomes were assessed at 3 and 6 months.

RESULTS

After 6 months, 29 patients in the home-based PR group and 28 in the control group completed the trial. The BMD of the lumbar spine and femoral neck in the home-based PR group was significantly higher than that in the control group (0.758 ± 0.048 vs. 0.728 ± 0.057, p = 0.031, 0.670 ± 0.024 vs. 0.658 ± 0.019, p = 0.039, respectively). There was no significant difference in FEV1% and FEV1/FVC between the groups. The mMRC, CAT, and Borg of the home-based PR group were significantly lower than those of the control group at 3 and 6 months (p < 0.05). The 6MWT of the home-based PR group was significantly higher than that of the control group at 3 and 6 months (p < 0.05).

CONCLUSIONS

Home-based PR improved BMD, dyspnea, symptoms, function, and daily living ability but not lung function in COPD patients with OP.