Hospital- and Home-Based Structured Pulmonary Rehabilitation in Recently Admitted COPD Patients: A Quasi-Experimental Study at Assiut University

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality and morbidity worldwide, significantly reducing patients' physical activity and quality of life. This study investigates a tailored pulmonary rehabilitation program combining hospital-based and home-based components over 12 weeks. The hospital component includes patient education, nutritional support, structured exercise training for both upper and lower limbs, and smoking cessation strategies. The home program emphasizes continuity with daily walking, strength exercises, and lifestyle modifications. The program aims to improve exercise capacity, dyspnea scores, and quality of life. Assessments include the six-minute walk test (6MWT), CAT score, mMRC dyspnea scale, spirometry, arterial blood gas analysis, and the St George's Respiratory Questionnaire. Measurements are collected at baseline and after program completion to assess improvements.

Inclusion criteria

• Stable COPD patients diagnosed based on spirometry (post-bronchodilator FEV1/FVC <70%)

Age > 40 years

Moderate to severe COPD stage

Able and willing to participate in rehabilitation program

Exclusion criteria

• Age < 40 years

Current acute COPD exacerbation at enrollment

Significant comorbid conditions limiting participation (e.g., uncontrolled diabetes mellitus, uncontrolled hypertension, left-sided heart failure, renal failure, liver cell failure)

Neuromuscular diseases, severe cognitive impairment, or psychiatric disturbance

Pregnant patients

Unwilling to participate in the rehabilitation program