Objective. To compare the effects of once- versus twice-weekly supervised pulmonary rehabilitation (PR) session on quality of life, anxiety and depressive symptoms and exercise tolerance in people with chronic obstructive pulmonary disease (COPD).

Methods. Data on 489 people with COPD who enrolled in an 8-week home-based PR programme, was retrospectively analyzed. Among them, 369 people performed once-weekly supervised home session (Gr 1) and 120 people performed twice-weekly (Gr 2).  The visual simplified respiratory questionnaire (VSRQ), hospital anxiety and depression scale (HAD) and six-minute stepper test (6MST) were assessed at baseline, after PR and at one-year follow-up.      

Results. At baseline, compared to people in Gr 2 (mean age, 65 ± 12 year; mean FEV1, 39 ± 17% of predicted value), participants in Gr 1 (mean age, 64 ± 11 year; mean FEV1, 39 ± 17% of predicted value), were more often in a relationship (69% vs 57%, p<0.05), required more often long-term oxygen therapy (70% vs 57%, p<0.01), and had a higher exercise tolerance (6MST score, 328 vs 258 strokes). In each group, all the outcomes were improved after PR and at one-year follow-up (p<0.01). The improvements were similar between groups, even after adjusting for baseline values (family situation, long-term oxygen therapy, exercise tolerance) (0.160 < p < 0.962).

Conclusion. Demonstrating that 8 home-based PR sessions were sufficient to achieve the same benefits than 16 sessions, these real-life results question the current PR guidelines and suggest that when personalized less than 10 sessions may be enough to achieve clinical and significant benefits.