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Home Based Rehabilitation

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Pulmonary rehabilitation is a cornerstone of care for people with chronic lung conditions. There is robust evidence that pulmonary rehabilitation improves exercise capacity, reduces symptoms, enhances health-related quality of life and reduces health care utilisation but the uptake of traditional centre-based pulmonary rehabilitation programs is generally low due issues including parking, transport, program location and competing needs.

Home-based pulmonary rehabilitation is an alternative model that aims to improve uptake and access and has been shown to have equivalent clinical outcomes to centre-based programs.

A home-based program may be suited to people who:

Do not live near a centre-based program

Do not own a car or have difficulty with public transport

Have work commitments that do not allow them to attend a centre-based program

Have young children at home

Are a primary caregiver in their home

Would prefer not to exercise in a group

Like the flexibility of being able to exercise when it suits them

Are medically unsuitable for a group-based program e.g. immunocompromised

It may not be suited to people who:

Are medically unstable and require in-person supervision whilst exercising

Prefer to exercise with a group

The burden of frequent travel to a centre-based program, in the setting of distressing exertional dyspnoea and mobility limitation, is consistently cited by patients as a barrier to attendance.

Referrals to a home-based pulmonary rehabilitation program are made in the same way as for a centre-based program.

After the initial assessment the patient may be able to choose to attend centre-based group sessions or to exercise at home with the guidance of weekly telephone calls from a health professional. This choice will not be available to patients who require direct supervision whilst exercising or if a home-based program is not yet available.