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. 2021 Sep 8;2021(9):CD009437. doi: 10.1002/14651858.CD009437.pub3

Wijkstra 1994.

Study characteristics
Methods RCT; follow‐up 12 weeks; control group: no treatment
Participants Randomised: 45
Completed: 43; I: 28, C: 15
Mean age I: 64 years, C: 62 years
Sex (% male): I: 82, C: 93
Inclusion criteria: diagnosis of COPD with FEV₁ % < 60%, FEV₁/IVC < 50%
Exclusion criteria: evidence of ischaemic heart disease, intermittent claudication, musculoskeletal disorder, other disabling disease that could restrict the rehab programme
Interventions Comprehensive rehabilitation programme at home
‐ Patients were supervised by a multi‐disciplinary team: pulmonologist, physiotherapist, nurse, GP
‐ Patients visited physiotherapist twice a week for 12 weeks and programme consisted of conventional physiotherapy, upper limb training, inspiratory muscle training, exercise training. Patients had to practice twice a day for a half hour at home
‐ Furthermore, they received education at home from a nurse (once a month)
‐ They visited the GP once a month, who supervised clinical status and maintenance treatment
Intervention duration: 3 months
Disciplines involved: GP, physiotherapist, nurse
Outcomes Lung function, CRQ, cycle ergometer test
Notes Dominant component: exercise
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "patients were stratified for their FEV₁ % predicted. After this stratification, the patients were randomly allocated"
Allocation concealment (selection bias) Low risk Quote: "(after randomisation), they were randomly allocated to one of three groups, each of 15 patients"
Blinding of participants and personnel (performance bias)
All outcomes High risk Comment: p articipants and treating therapists not likely to have been blinded to group allocation
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk Comment: w e could not ascertain how and whether outcome assessors were blinded to treatment group assignment
Incomplete outcome data (attrition bias)
All outcomes Low risk Comment: o nly 2 (out of 30) dropouts in rehabilitation group vs no dropouts in control group
Selective reporting (reporting bias) Low risk Comment: a ll outcomes reported