Table 1– European versus North American pulmonary rehabilitation programmes
EuropeNorth Americap-value
Subjects n188187
Setting
 Outpatient48.971.7<0.001
 Inpatient16.03.7
 Both29.323.0
 Other5.81.6
Types of reimbursement#
 Own insurance38.392.5<0.001
 Government62.838.5<0.001
 Own money10.643.3<0.001
 Work insurance3.719.3<0.001
 Not funded2.70.50.22
 Other0.50.50
Pulmonary rehabilitation team members
 Chest physician87.862.0<0.001
 Physiotherapist95.217.1<0.001
 Occupational therapist36.217.1<0.001
 Social worker42.624.1<0.001
 Psychologist53.78.6<0.001
 Dietician76.193.5<0.001
 Exercise physiologist25.562.6<0.001
 Internist11.78.00.30
 Cardiologist43.020.0<0.001
 General practitioner18.113.40.26
 Pharmacist22.918.20.31
 Nurse68.164.20.45
 Respiratory therapist1.659.9<0.001
Number of team members6 (4–8)4 (3–6)<0.001
Referral sites#
 Chest physicians96.895.70.60
 General practitioners55.992.5<0.001
 Self-referral21.333.70.008
 Specialist respiratory nurse12.23.70.001
 Cardiologist1.19.1<0.001
Median number of individuals per pulmonary rehabilitation programme+76 to 10546 to 75<0.001
Estimated total pulmonary rehabilitation enrolments in 2011 n19 51511 475<0.001
Median percentage of pulmonary rehabilitation completers76 to 9061 to 75<0.001
Case mix#
 Stable COPD95.798.90.11
 Unstable COPD74.575.90.81
 Restrictive lung disease§66.582.40.001
 Asthma63.382.9<0.001
 Post-thoracic surgery61.785.0<0.001
Length of pulmonary rehabilitation programme weeks8 (5.6–12)11 (8–12)<0.001
Number of pulmonary rehabilitation sessions per week2.5 (2–4)2.5 (2–3)0.005
Duration of pulmonary rehabilitation session h2 (1.3–2)1.5 (1–1.5)<0.001
Total pulmonary rehabilitation hƒ39.3 (25.0–62.5)36 (30–48)0.33
Most important outcomes#
 Quality of life81.483.40.68
 6-min walk test33.053.5<0.001
 Dyspnoea48.435.80.016
 Depression3.29.10.019
 Physical activity33.521.90.02
 Self-management skills33.530.50.58
 Smoking cessation5.916.00.002
 Activities of daily living28.736.40.12
Interventions#
 Outdoor walking43.65.9<0.001
 Treadmill walking68.697.9<0.001
 Stationary cycling89.497.30.003
 Resistance training using training apparatus62.867.90.33
 Resistance training using handheld weights71.393.6<0.001
 Education89.998.9<0.001
 ECT/ADL training64.994.7<0.001
 Self-management training75.585.0<0.001
 Nutritional support76.193.6<0.001
 Inspiratory muscle training54.849.70.35
 Neuromuscular electrical stimulation29.31.6<0.001
 Breathing exercise including PLB86.797.9<0.001
 Smoking cessation76.683.40.12
 Psychosocial support64.981.8<0.001
Number of types of interventions10 (8–12)11 (10–12)0.0041
  • Data are presented as % of pulmonary rehabilitation programmes or median (interquartile range), unless otherwise stated. COPD: chronic obstructive pulmonary disease; ECT: energy conservation techniques; ADL: activities of daily life; PLB: pursed lips breathing. #: sum of proportions exceeds 100% as respondents were allowed or asked to choose more than one option; : pulmonary rehabilitation team members with a prevalence of ≥10% in one or both continents; +: 50% of the programmes enrolled 76 to 105 patients (Europe) or 46 to 75 patients (North America) or more in 2011; §: always including interstitial lung disease and sometimes including thoracic wall diseases; ƒ:weeks × sessions × time per session.