Telerehabilitation Programme as a Maintenance Strategy for COPD Patients: A 12-Month Randomized Clinical Trial

Gáldiz, Juan B.; Gómez, Alba; Rodríguez, Diego A.; Güell, Rosa; Cebollero, Pilar; Hueto, Javier; Cejudo, Pilar; Ortega, Francisco; Sayago, Itxaso; Chic, Susana; Urrutia, Marta Íscar; Diago, Carlos Antonio Amado; Trigo, Gemma Rodríguez; Cosío, Borja G.; Bustamante, Vı́ctor; Pijoan, Josèc) Ignacio

doi:10.1016/j.arbres.2020.03.034

Cited by 26 publications

(51 citation statements)

References 34 publications

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“…Patients were provided with dumbbells and a stationary bike, and an app that guided them through aerobic and resistance exercises. While there were improvements in exercise capacity (mean 6MWD change = 19.9 m) and HRQL (measured with the CRQ), these improvements were not significant [25].…”

Section: Ehealth and Mhealthmentioning

confidence: 75%

“…The authors hypothesized that perhaps both the exercises prescribed and the technology used were not sufficiently motivating or stimulating for at-home exercise and suggested that future work should incorporate motivational strategies (e.g., gaming technologies) and exercise variation to improve motivation [24]. A recent RCT evaluated whether use of an app after conventional PR was effective in maintaining the benefits achieved during PR [25]. Patients were provided with dumbbells and a stationary bike, and an app that guided them through aerobic and resistance exercises.…”

Section: Ehealth and Mhealthmentioning

confidence: 99%

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Promoting Exercise Training Remotely

Robinson

Moy

2022

Life

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There has been increased incentivization to develop remote exercise training programs for those living with chronic respiratory diseases, such as chronic obstructive pulmonary disease (COPD). Remote programs offer patients an opportunity to overcome barriers to accessing traditional in-person programs, such as pulmonary rehabilitation (PR). Methods to deliver exercise training remotely range in complexity and types of technological modalities, including phone calls, real-time video conferencing, web- and app-based platforms, video games, and virtual reality (VR). There are a number of studies demonstrating the effectiveness of these programs on exercise capacity, dyspnea, and health-related quality of life (HRQL). However, there is great variation in these programs, making it difficult to assess findings across studies. Other aspects that contribute to the effectiveness of these programs include stakeholder perceptions, such as motivation and willingness to engage, and adherence. Finally, while the intent of these remote programs is to overcome barriers to access, they may inadvertently exacerbate access disparities. Future program development efforts should focus on standardizing how remote exercise training is delivered, engaging stakeholders early on to develop patient-centered programs that patients will want to use, and understanding the heterogeneous preferences and needs of those living with chronic respiratory disease in order to facilitate engagement with these programs.

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Section: Ehealth and Mhealthmentioning

confidence: 75%

Section: Ehealth and Mhealthmentioning

confidence: 99%

Promoting Exercise Training Remotely

Robinson

Moy

2022

Life

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“…Out of them, five articles were removed because of not meeting the inclusion criteria. Thirteen studies were retained for the final analysis [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ].…”

Section: Resultsmentioning

confidence: 99%

Telerehabilitation as a Form of Pulmonary Rehabilitation in Chronic Lung Disease: A Systematic Review

et al. 2022

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Introduction: Tele-rehabilitation is increasingly used to deliver pulmonary rehabilitation. The aim of this systematic review was to compare the effect between tele-pulmonary rehabilitation and classical supervised pulmonary rehabilitation. Method: Three databases were analysed (PubMed, PEDro, Scopus). The selection and evaluation of studies followed the PRISMA guidelines. The risk of bias was evaluated using the PEDro Scale. Results: From the initial selection (n = 245), ten studies were retrieved, including from 10 to 67 patients. All but two (IPF) included patients with COPD. Based on the FEV1, patients with COPD were mainly categorised as moderate and severe. The teleactivities were heterogenous in terms of proposed exercises and way of settings and often not in agreement with the guidelines about pulmonary rehabilitation. Despite this, the effects of the interventions were globally positive on functional exercise capacity, quality of life, anxiety and depression, and impact of COPD on personal life but not on dyspnoea. The PEDro scores varied from 4 to 8. The adherence was higher than 80% when supervision during the exercise was included. Conclusion: This review demonstrated that the telerehabilitation is safe and well accepted by the patients, and could be considered as one option of classical pulmonary rehabilitation to improve the functional exercise capacity, quality of life, anxiety and depression, and the impact of COPD on personal’s life. This conclusion cannot be extrapolated to the other chronic lung diseases due to the lack of data.

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“…Therefore, the simple evaluation of diaphragmatic excursion at rest in COPD patients may be a simple, cheap, and safe prognostic measurement in clinical practice. It remains to be demonstrated whether it can be improved with rehabilitation of exercise 20 and if this improvement may result in a reduction in the risk of future exacerbations.…”

Section: Discussionmentioning

confidence: 99%

Diaphragmatic Movement at Rest and After Exertion: A Non-Invasive and Easy to Obtain Prognostic Marker in COPD

Mekov¹,

Yanev²,

Kurtelova³

et al. 2022

COPD

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Introduction Diaphragmatic dysfunction is common in patients with chronic obstructive pulmonary disease (COPD). This study aimed to assess the prognostic significance of impaired diaphragmatic movement at rest and after exercise. Methods This was a prospective study of patients with stable COPD. Diaphragmatic movements were examined at rest and after a 6-minute walking test (6MWT) with a convex transducer with a frequency of 3.5-5-7.5 MHz. Maximal movement of the diaphragm was measured in both right and left diaphragm, and the side with higher amplitude was selected for further analysis. Measurements obtained were evaluated for their prognostic value for a composite endpoint of moderate and severe COPD exacerbations and death in 1 year time period was assessed. In addition, postbronchodilator spirometry, symptoms, quality of life, and demographic and clinical information were collected. Results A total of 96 patients were analyzed (62.5% male, mean age 65.1 years (standard deviation (SD): 8.1), mean FEV1 (% predicted): 55.8%, SD: 18.3%, mean CAT: 15.6 units, SD: 9.2). Sixty-four patients (67%) presented the composite endpoint. In the multivariate Cox analysis, FVC (HR = 0.944, p = 0.005), CAT score (HR = 1.133, p = 0.011), previous severe exacerbations (HR = 5.446, p = 0.004) and diaphragmatic movement at rest (HR = 0.932, p = 0.033) were found to be predictors of the composite endpoint. This model correctly classified 86.5% (83/96) of the patients. Conclusion Non-invasive assessment of diaphragmatic movement by ultrasound measurement both at rest and after exercise could contribute to the assessment of disease severity and prognosis of COPD.

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Telerehabilitation Programme as a Maintenance Strategy for COPD Patients: A 12-Month Randomized Clinical Trial

Cited by 26 publications

References 34 publications

Promoting Exercise Training Remotely

Promoting Exercise Training Remotely

Telerehabilitation as a Form of Pulmonary Rehabilitation in Chronic Lung Disease: A Systematic Review

Diaphragmatic Movement at Rest and After Exertion: A Non-Invasive and Easy to Obtain Prognostic Marker in COPD

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