Home-based and telehealth pulmonary rehabilitation were as effective as center-based programs for improving exercise capacity, quality of life, and dyspnea in adults with COPD.
Systematic Review
Does home-based and telehealth pulmonary rehabilitation improve exercise capacity, quality of life, and dyspnea compared to center-based PR or usual care in adults with COPD?
Home-based and telehealth pulmonary rehabilitation are effective and safe alternatives to center-based programs for improving exercise capacity and quality of life in patients with COPD, particularly for those facing access barriers.
Abstract Introduction Pulmonary rehabilitation (PR) is a cornerstone intervention for chronic obstructive pulmonary disease (COPD), improving exercise capacity, health-related quality of life, and symptom burden. However, access to center-based PR is limited by geographic, financial, and logistical barriers, prompting increased interest in home-based and telehealth modalities. Methods This umbrella review synthesized evidence from recent meta-analyses, systematic reviews, and clinical guidelines published between 2015 and 2025. Studies comparing home-based, telehealth, and center-based PR in adults with COPD were included. Outcomes assessed were exercise capacity, quality of life, dyspnea, program adherence, and adverse events. Certainty of evidence was evaluated using GRADE methodology. Results Home-based and telehealth PR programs demonstrated comparable improvements in exercise capacity and health-related quality of life to center-based PR, with no significant differences in safety or adverse events. Meta-analyses showed significant gains in six-minute walk distance and dyspnea scores for both home-based and center-based PR compared to usual care. Program completion rates were higher for home-based and telehealth modalities. Initiation of PR after hospitalization for acute exacerbation reduced readmissions and mortality, with benefits maintained for at least 12 months. However, long-term maintenance of gains remains challenging. Discussion The evidence supports the use of home-based and telehealth PR as effective alternatives to center-based programs, particularly for patients facing access barriers. Heterogeneity in program design, delivery, and reporting limits generalizability, and the overall methodological quality of some studies is low. Supervised center-based PR remains the standard of care, but home-based and telehealth options are valuable for those unable to attend in-person programs. Individualized approaches and behavioral interventions may enhance long-term adherence and outcomes. Conclusion Home-based and telehealth pulmonary rehabilitation are as effective as center-based programs for improving exercise capacity, quality of life, and dyspnea in COPD. These modalities should be considered for patients unable to access traditional PR, with attention to individualized program design and strategies to sustain long-term benefits. This abstract is funded by: None
Paudel et al. (Fri,) conducted a systematic review in Chronic obstructive pulmonary disease (COPD). Home-based and telehealth pulmonary rehabilitation vs. Center-based pulmonary rehabilitation was evaluated on Exercise capacity, quality of life, dyspnea, program adherence, and adverse events. Home-based and telehealth pulmonary rehabilitation were as effective as center-based programs for improving exercise capacity, quality of life, and dyspnea in adults with COPD.