Gupta RB, Brooks D, Lacasse Y, Goldstein RS
Chest. 2006;130(4):1089-1095.
Objective
The purpose of this study was to evaluate the influence of rollator use on health-related quality of life in patients with COPD.
Design.
Randomized controlled trial.
Methods.
Thirty-one postrehabilitation patients with COPD were randomized to receive a rollator (n = 18) or usual care (n = 13) for 8 weeks and to record the frequency of rollator use. Outcome measures at baseline, 4 weeks, and 8 weeks included the Chronic Respiratory Questionnaire (CRQ) and the 6-min walk (6MW).
Results.
During acute testing, subjects consistently walked further when assisted (baseline 6MW: 292 +/- 67 m vs 263 +/- 67 m; 8 weeks: 283 +/- 65 m vs 259 +/- 68 m [+/-SD]; P = 0.013). However, provision of a rollator at home was not associated with group differences in the CRQ (P > 0.08) or in the unassisted 6MW (P = 0.4) or the assisted 6MW (P = 0.5). Eight of 18 subjects assigned to the rollator group used the rollator less than three times per week. Regular users demonstrated a consistent improvement in mastery compared with infrequent users (4 weeks: 4.7 +/- 0.6 vs 5.2 +/- 0.8, respectively; 8 weeks: 5.3 +/- 0.8 vs 4.7 +/- 0.4; P = 0.014).
Conclusions.
Despite evidence of effectiveness during acute testing, this study did not demonstrate a rollator effect on quality of life or exercise capacity when the rollator was provided at home, for a longer period. Actual use of a rollator may be an important determinant of its effect. Therefore, when prescribing a rollator, health-care professionals should attempt to identify those most likely to use it.
Clinical Commentary.
The effectiveness of supplemental aids for patients with COPD to use in the outpatient environment has received little attention. The use of a rollator by patients with COPD (during acute testing) has been shown in previous studies to be an effective means to improve various outcomes. Although this study did not show a group effect in the home setting, an improvement in mastery was noted in those patients who regularly used the device. The identification of patients who would be appropriate candidates for the use of this therapy is important and deserves further study.
BC