Rethinking Pulmonary Rehabilitation - a Three-arm Randomised Multicentre Trial

"PTR is delivered from promoter hospital to a group of 4-6 patients who exercise at home and communicate via tablet-camera.~Each session is 60 min; 35 min exercise/ 25 min patient education, two times per week for a duration of 10-weeks (primary endpoint).~Specific exercises are evidence-based; been used in several intervention studies on patients with COPD.~Exercises involves larger muscle groups with 50/50 exercises for upper and lower extremities. Volume, intensity and content exercise protocol follow both national and international exercise recommendations.~The education sessions consist of dialogue, reflections around empowerment and better living with COPD.~Every fourth education session consists of 25 min Mindfulness exercises developed for COPD patients.~After 10-weeks of PTR, participants are offered once weekly PTR for 60min in groups of 4-8 persons throughout a 65-week maintenance period (secondary endpoint 75-weeks from baseline)."

"HPR is an individual self-initiated home-based PR aiming to achieve 20 min of self-initiated muscle-endurance based exercise; 3-days/weekly for 10-weeks (primary endpoint).~Exercises are evidence-based; used in several intervention studies on patients with COPD and involves larger muscle groups with 50/50 exercises for upper/lower extremities.~First session is a home visit by a respiratory physiotherapist. During the visit the physiotherapist and patient establish exercise goals, exercise prescription and provision of mindfulness exercises and educationbook.~The home visit is followed by one weekly session for 10-weeks. A menu of topics relevant to COPD and self-management is discussed. A session is delivered from promoter hospital via tablet-camera or telephone call (patients' preference).~After 10-weeks of HPR, participants are offered once weekly PTR for 60min in groups of 4-8 persons throughout a 65-week maintenance period (secondary endpoint 75-weeks from baseline)."

"Receive usual care; medication, scheduled follow-up visit and possible phone contact with GP and the outpatient respiratory department.~Except for assessment visits 10-, 35-, and 75-weeks from baseline no intervention is offered.~If a patient changes his/her mind and wishes to participate in a conventional hospital- or community-based PR program, it will be granted as this is a highly recommended treatment (e.g. rehabilitation after hospital admitted exacerbation)."