Abstract
BACKGROUND: Pulmonary rehabilitation is a key and effective treatment for people with chronic obstructive pulmonary disease (COPD) although lack of accessibility is a barrier. The aim of this study was to compare the effects of face-to-face supervision (FFS) with those of telephone supervision (TS) during a community-based pulmonary rehabilitation programme to increase functional exercise capacity in people with COPD using minimal equipment. In addition, physical activity level, health-related quality of life, psychological status, exercise self-efficacy, number of exacerbations and adherence were analysed. METHODS: A single-blind randomized clinical trial was designed, allocating 80 patients from primary care setting 1:1 to FFS (n = 40) or TS (n = 40) rehabilitation programme. The intervention lasted 13 weeks and was composed of a structured education and exercise training. The variables evaluated were functional exercise capacity (6-minute walk distance [6MWD]), physical activity level (steps/day), health-related quality of life (COPD Assessment Test [CAT]), psychological status (Hospital Anxiety and Depression Scale), exercise self-efficacy (Exercise Self-Efficacy Scale), number of exacerbations and adherence (Adherence to Treatment of Physiotherapy Scale). RESULTS: Eighty participants were included in this study. Compared with the TS group, the FFS group presented improvements in the 6MWD of 28.8 m (95%CI 12.3–45.3, p < 0.01) after the intervention, 19.15 m (95%CI 2.7–35.6, p < 0.05) at 6 months, and 28 m (95%CI 11.5–44.5, p < 0.01) at 12 months, as well as the CAT score (mean: -4.2, -3.1, and − 4.6 points) respectively. Compared with the TS group, the FFS group performed an increased number of steps/day at the end of the intervention and at 12 months and had a reduced anxiety level at the 6-month follow-up. No differences in depression level, exercise self-efficacy, number of exacerbations or adherence were observed. CONCLUSIONS: Compared with TS, FFS was superior for improving functional exercise capacity, health-related quality of life and physical activity levels in the short and long term in individuals with COPD. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05565872 (https://clinicaltrials.gov/study/NCT05565872). Initial release: 09/27/2022. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12875-025-02962-3.