Effects of Home-Based Pulmonary Rehabilitation on Walking, Anxiety and Sleep in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Abstract

Aim: This study aims to evaluate whether an 8-week, nurse-led, home-based pulmonary rehabilitation programme improves walking capacity, anxiety and sleep quality in adults with chronic obstructive pulmonary disease. Methods: This was a single-centre, open-label, parallel-group randomized controlled trial with assessments at baseline and week 8. Ninety adults with stable COPD (GOLD II–III) were enrolled and randomized 1:1 (fixed-block size = 2; SNOSE concealment); 84 completed week-8 assessments and were analysed (home-based rehabilitation, n = 43; standard care, n = 41). Participants' mean age was 67.71 years; 73.8% were male; mean baseline FEV1 was 55% predicted. The 8-week intervention comprised home-based breathing and full-body resistance exercises (3–5×/week, 25–30 min), initiated with a tele-monitored session to ensure correct technique and supported by weekly nurse-led calls, alongside structured nurse-delivered education. Prespecified primary outcomes were 6-min walk distance, anxiety (STAI) and sleep quality (PSQI); secondary outcomes were cardiopulmonary signs, dyspnoea and spirometric indices. Results: At week 8, the intervention improved walking capacity versus control (p < 0.001). Anxiety decreased on STAI-I/II (p < 0.001), and overall sleep quality improved on PSQI (p = 0.001), with benefits on Subjective Sleep Quality and Daytime Dysfunction (both p < 0.001); effects on Sleep Disturbances and Sleep Medication were smaller. Dyspnoea (Borg) also improved (p < 0.001). Secondary outcomes were consistent, and no intervention-related adverse events occurred. Conclusion: Nurse-led, home-based pulmonary rehabilitation is a feasible and safe approach that improves functional capacity as well as psychological and sleep outcomes in adults with chronic obstructive pulmonary disease. Trial Registration: ClinicalTrials.gov identifier: NCT06862713.