Telerehabilitation for chronic respiratory disease

Cox, Narelle S; Corso, Simone Dal; Hansen, Henrik; McDonald, Christine F; Hill, Catherine J.; Zanaboni, Paolo; Alison, Jennifer A.; O’Halloran, Paul; Macdonald, Heather M.; Holland, Anne E

doi:10.1002/14651858.cd013040.pub2

Cited by 183 publications

(210 citation statements)

References 119 publications

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“…Demonstrating clinically meaningful and sustainable effects of the TERECO programme on 6MWD and LMS, this study adds to previous low-certainty evidence on the effectiveness of telerehabilitation in respiratory disease. 14 The effect size for 6MWD in the present study at 6 weeks is comparable to results from a randomised controlled trial from Hong Kong, 10 which evaluated a 6-week outpatient exercise programme for SARS survivors with baseline and post-treatment assessment. In contrast to our findings, the latter study did not detect any effects of the programme on HRQOL (SF-36) or LMS (measured as gluteus maximum and anterior deltoid strength with dynamometer).…”

Section: Discussionsupporting

confidence: 78%

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A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomised controlled trial

Xia

Zhan³

et al. 2021

Thorax

153

316

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ObjectivesTo investigate superiority of a telerehabilitation programme for COVID-19 (TERECO) over no rehabilitation with regard to exercise capacity, lower limb muscle strength (LMS), pulmonary function, health-related quality of life (HRQOL) and dyspnoea.DesignParallel-group randomised controlled trial with 1:1 block randomisation.SettingThree major hospitals from Jiangsu and Hubei provinces, China.Participants120 formerly hospitalised COVID-19 survivors with remaining dyspnoea complaints were randomised with 61 allocated to control and 59 to TERECO.InterventionUnsupervised home-based 6-week exercise programme comprising breathing control and thoracic expansion, aerobic exercise and LMS exercise, delivered via smartphone, and remotely monitored with heart rate telemetry.OutcomesPrimary outcome was 6 min walking distance (6MWD) in metres. Secondary outcomes were squat time in seconds; pulmonary function assessed by spirometry; HRQOL measured with Short Form Health Survey-12 (SF-12) and mMRC-dyspnoea. Outcomes were assessed at 6 weeks (post-treatment) and 28 weeks (follow-up).ResultsAdjusted between-group difference in change in 6MWD was 65.45 m (95% CI 43.8 to 87.1; p<0.001) at post-treatment and 68.62 m (95% CI 46.39 to 90.85; p<0.001) at follow-up. Treatment effects for LMS were 20.12 s (95% CI 12.34 to 27.9; p<0.001) post-treatment and 22.23 s (95% CI 14.24 to 30.21; p<0.001) at follow-up. No group differences were found for lung function except post-treatment maximum voluntary ventilation. Increase in SF-12 physical component was greater in the TERECO group with treatment effects estimated as 3.79 (95% CI 1.24 to 6.35; p=0.004) at post-treatment and 2.69 (95% CI 0.06 to 5.32; p=0.045) at follow-up.ConclusionsThis trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and physical HRQOL.Trial registration numberChiCTR2000031834.

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Section: Discussionsupporting

confidence: 78%

“…12 Telerehabilitation provides a viable alternative that could be superior to no rehabilitation and as effective as conventional rehabilitation. 13 14 We investigated possible superiority of a telerehabilitation programme for COVID-19 (TERECO) over no rehabilitation with regard to functional exercise capacity, lower limb muscle strength…”

Section: Introductionmentioning

confidence: 99%

A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomised controlled trial

Xia

Zhan³

et al. 2021

Thorax

153

316

View full text Add to dashboard Cite

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“…A 2021 Cochrane review of tele-rehabilitation [ 62 ] included 15 studies totaling 1904 patients, 99% of whom had COPD. Exercise training was required for inclusion in the review, with at least 50% of the intervention given via tele-rehabilitation.…”

Section: Telemedicinementioning

confidence: 99%

The Role of Telemedicine in Extending and Enhancing Medical Management of the Patient with Chronic Obstructive Pulmonary Disease

2021

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Medical management of a chronic obstructive pulmonary disease (COPD) patient must incorporate a broadened and holistic approach to achieve optimal outcomes. This is best achieved with integrated care, which is based on the chronic care model of disease management, proactively addressing the patient’s unique medical, social, psychological, and cognitive needs along the trajectory of the disease. While conceptually appealing, integrated care requires not only a different approach to disease management, but considerably more health care resources. One potential way to reduce this burden of care is telemedicine: technology that allows for the bidirectional transfer of important clinical information between the patient and health care providers across distances. This not only makes medical services more accessible; it may also enhance the efficiency of delivery and quality of care. Telemedicine includes distinct, often overlapping interventions, including telecommunication (enhancing lines of communication), telemonitoring (symptom reporting or the transfer of physiological data to health care providers), physical activity monitoring and feedback to the patient and provider, remote decision support systems (identifying “red flags,” such as the onset of an exacerbation), tele-consultation (directing assessment and care from a distance), tele-education (through web-based educational or self-management platforms), tele-coaching, and tele-rehabilitation (providing educational material, exercise training, or even total pulmonary rehabilitation at a distance when standard, center-based rehabilitation is not feasible). While the above components of telemedicine are conceptually appealing, many have had inconsistent results in scientific trials. Interventions with more consistently favorable results include those potentially modifying physical activity, non-invasive ventilator management, and tele-rehabilitation. More inconsistent results in other telemedicine interventions do not necessarily mean they are ineffective; rather, more data on refining the techniques may be necessary. Until more outcome data are available clinicians should resist being caught up in novel technologies simply because they are new.

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“…Telerehabilitation is defined as a telehealth application using telecommunication technologies to administer the rehabilitation services so that patient receives supervised rehabilitation at home while the rehab specialist is at the hospital [76]. It is well established that telerehabilitation used in PR of chronic respiratory diseases produces similar results as compared to center-based PR with no identified safety issues [77]. It is already proven that physiotherapists are uniquely positioned to play an essential role in helping individuals who are at risk of functional decline in the current pandemic situation.…”

Section: Scope and Future For Telerehabilitationmentioning

confidence: 99%

Revisiting pulmonary rehabilitation during COVID-19 pandemic: a narrative review

Dixit¹,

Borghi‐Silva²,

Bairapareddy³

2021

Reviews in Cardiovascular Medicine

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There has been an apparent association between the risks of complications with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in patients with a history of existing chronic respiratory diseases during the pandemic of coronavirus disease 2019 . SARS-CoV-2 poses a severe risk in cardiopulmonary management. Moreover, chronic respiratory diseases may further amplify the risk of morbidity and mortality among the afflicted population in the pandemic era. The present review outlines the importance of pulmonary rehabilitation (PR) in persons with chronic respiratory diseases (Chronic obstructive pulmonary disease (COPD) and Asthma) during the COVID-19 era. In this context, amongst the population with a pre-existing pulmonary diagnosis who have contracted SARS-CoV-2, following initial medical management and acute recovery, exercise-based pulmonary rehabilitation (PR) may play a crucial role in long-term management and recovery. The energy conservation techniques will play a pragmatic role in PR of mild to moderate severity cases to counter post-COVID-19 fatigue. Moreover, there is also an urgent need to effectively address post-COVID-19 anxiety and depression, affecting the PR delivery system.

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Telerehabilitation for chronic respiratory disease

Abstract: Trusted evidence. Informed decisions. Better health.

Cited by 183 publications

References 119 publications

A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomised controlled trial

A telerehabilitation programme in post-discharge COVID-19 patients (TERECO): a randomised controlled trial

The Role of Telemedicine in Extending and Enhancing Medical Management of the Patient with Chronic Obstructive Pulmonary Disease

Revisiting pulmonary rehabilitation during COVID-19 pandemic: a narrative review

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