A Telerehabilitation Program for Maintaining Functional Capacity in Patients With Chronic Lung Diseases During a Period of COVID-19 Social Isolation: Quasi-Experimental Retrospective Study

Abstract

Background Pulmonary diseases represent a great cause of disability and mortality in the world, and given the progression of these pathologies, pulmonary rehabilitation programs have proven to be effective for people with chronic respiratory diseases. During the COVID-19 pandemic, telerehabilitation has become an alternative for patients with such diseases. Objective The aim of this study was to compare the outcomes (ie, functional capacity and quality of life) of telerehabilitation to those of usual care among patients who previously participated in face-to-face pulmonary rehabilitation programs. Methods We conducted a quasi-experimental retrospective study from April 2020 to August 2021. A total of 32 patients with chronic lung diseases were included and divided into the control and intervention groups. The intervention group performed telerehabilitation synchronously twice per week and was supervised by a physical therapist during breathing, strengthening, and aerobic exercises. Changes in the degree of dyspnea and leg discomfort were assessed based on changes in Borg scale scores. The control group did not perform any activities during the period of social isolation. Functional capacity was assessed with the 6-minute walk test, and quality of life was assessed with the Medical Outcomes Study 36-item Short Form Health Survey. Results The telerehabilitation group’s mean 6-minute walk distance decreased by 39 m, while that of the control group decreased by 120 m. There was a difference of 81 m between the groups’ mean 6-minute walk distances (P=.02). In relation to the quality of life, telerehabilitation was shown to improve the following two domains: social functioning and mental health. Conclusions Telerehabilitation programs for patients with chronic lung diseases can ease the deleterious effects of disease progression, be used to maintain functional capacity, and improve aspects of quality of life.

Remote pulmonary rehabilitation for interstitial lung disease: developing the model using experience-based codesign

“…Therefore, the final programme involved an in-person assessment and videoconference PR delivered in line with PR guidelines. 2 16 28 This is contrast to previous research of remote PR programmes in ILD where the exercise component was predominantly unsupervised 8 9 11-15 or supervised using a virtual physiotherapist 10 and delivered on a telerehabilitation platform, [9][10][11][12] Wii Fit 8 or at home. 10 13-15 Regarding the exercise component, participants recommended allocating service-users with similar levels of functional ability to the same group, the use of simple exercise equipment available in the home (eg, chair) supplemented with free weights or elastic bands provided by the PR service, the prescription of highintensity interval aerobic training, and an unsupervised session involving continuous aerobic exercise.…”

“…Similar to previous qualitative research,20 the importance of the social aspect of the programme was emphasised by people with ILD, in particular having an opportunity to access peer support. It is noteworthy that previous studies of remote programmes in ILD did not include this in the intervention,8–15 therefore, its impact has not been investigated. For people with ILD, peer support provides a way to connect with other people with the same disease and is an enabler of exercise 20.…”

“…Therefore, the final programme involved an in-person assessment and videoconference PR delivered in line with PR guidelines 2 16 28. This is contrast to previous research of remote PR programmes in ILD where the exercise component was predominantly unsupervised8 9 11–15 or supervised using a virtual physiotherapist10 and delivered on a telerehabilitation platform,9–12 Wii Fit8 or at home 10 13–15…”

“…For example, of 1904 participants analysed as part of a Cochrane review of telerehabilitation for chronic respiratory disease, only 2 were diagnosed with ILD. 5 Three randomised controlled trials (RCTs) [8][9][10] published since the Cochrane review, and a number of cohort studies [11][12][13][14][15] that investigated remote models predominantly recruited participants with idiopathic pulmonary fibrosis (IPF) rather than ILD, investigated heterogeneous interventions, reported conflicting results and were limited by small sample sizes. Furthermore, the interventions in these studies were not adapted for ILD.…”