Background: Pulmonary Rehabilitation for moderate Chronic Obstructive Pulmonary Disease in primary care could\r\nimprove patients� quality of life.\r\nMethods: This study aimed to assess the efficacy of a 3-month Pulmonary Rehabilitation (PR) program with a\r\nfurther 9 months of maintenance (RHBM group) compared with both PR for 3 months without further maintenance\r\n(RHB group) and usual care in improving the quality of life of patients with moderate COPD.\r\nWe conducted a parallel-group, randomized clinical trial in Majorca primary health care in which 97 patients with\r\nmoderate COPD were assigned to the 3 groups. Health outcomes were quality of life, exercise capacity, pulmonary\r\nfunction and exacerbations.\r\nResults: We found statistically and clinically significant differences in the three groups at 3 months in the emotion\r\ndimension (0.53; 95%CI0.06-1.01) in the usual care group, (0.72; 95%CI0.26-1.18) the RHB group (0.87; 95%CI 0.44-1.30)\r\nand the RHBM group as well as in fatigue (0.47; 95%CI 0.17-0.78) in the RHBM group. After 1 year, these differences\r\nfavored the long-term rehabilitation group in the domains of fatigue (0.56; 95%CI 0.22-0.91), mastery (0.79; 95%CI 0.03-\r\n1.55) and emotion (0.75; 95%CI 0.17-1.33). Between-group analysis only showed statistically and clinically significant\r\ndifferences between the RHB group and control group in the dyspnea dimension (0.79 95%CI 0.05-1.52). No differences\r\nwere found for exacerbations, pulmonary function or exercise capacity.\r\nConclusions: We found that patients with moderate COPD and low level of impairment did not show meaningful\r\nchanges in QoL, exercise tolerance, pulmonary function or exacerbation after a one-year, community based\r\nrehabilitation program. However, long-term improvements in the emotional, fatigue and mastery dimensions (within\r\nintervention groups) were identified.
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