Self-reported maintenance training in patients with COPD – a 56 months’ follow-up study after initial pulmonary rehabilitation

In our previous RCT, short-term effects of pulmonary rehabilitation (PR) for chronic obstructive pulmonary disease (COPD) were associated with attendance rate in a dose-response pattern, regardless of whether PR contained conventional physical exercise training or Singing for Lung Health. In this 56 months’ follow-up study, we aimed to investigate if current self-reported maintenance training was correlated with initial PR adherence. We hypothesised that maintenance training was related to PR adherence in the past. In 2023, RCT participants, who were still alive, were contacted (n=196; 73% of 270), included (n=159; 81% of 196), and interviewed via telephone. We explored data using stratified analyses and logistic regression. In total, 30 participants had dropped out during the initial RCT. At long-term follow-up, these non-completers were currently more frequently smokers (p=0.04) and less active than completers (38% vs 60%; p=0.03), regardless of initial RCT randomisation. Moreover, they had decreased QoL (St George’s Respiratory Questionnaire): mean change from since RCT: Non-completers: 4.0 (SD 15.6); Completers: -3.5 (SD 13.9). Current maintenance training was related to maintained QoL (p=0.04; OR: 2.4, 95% CI [1.0; 5.4]). Our study suggests that long-term maintenance training and maintenance of PR effects are positively associated with completion of an initial PR programme – irrespectively of randomisation to SLH or PExT. Therefore, we see a need for future PR programmes to include support of maintenance training after PR, and additional attention – including smoking cessation support - should be given to activate those who do not complete PR.