There’s no place like home: Integrating pulmonary rehabilitation into the home setting

Abstract

Traditional, outpatient pulmonary rehabilitation provided to stable chronic obstructive pulmonary disease (COPD) patients leads to significant improvements in dyspnea, exercise capacity and health related quality of life. Also, when started during or shortly after a hospitalization for a COPD exacerbation, pulmonary rehabilitation improves these patient-centered outcomes and arguably reduces subsequent health care utilization and mortality. Despite these benefits, the uptake of traditional pulmonary rehabilitation remains disappointingly poor. Homebased pulmonary rehabilitation, a safe and effective alternative to traditional, center-based programs, can broaden access. While proven improvements in dyspnea, exercise capacity and health status justify implementation of home-based pulmonary rehabilitation, it would be helpful to know whether it can also decrease health care utilization and be cost-effective.

Systematic review of clinical effectiveness, components, and delivery of pulmonary rehabilitation in low-resource settings

“…A home-based, inexpensively equipped PR service with minimal attendance at a potentially distant centre may be more suitable model in rural areas with limited resources and poor transport infrastructure 65,66 . In home-based models, the cost to the patient is minimised, and people have flexibility in how they invest their time [67][68][69] . Digital technology is a rising paradigm in LMICs, which may be considered in developing a remote model of PR service 70 .…”

Influence of Baduanjin on lung function, exercise capacity, and quality of life in patients with mild chronic obstructive pulmonary disease

“…[ 13 ] However, traditional pulmonary rehabilitation requires a series of professional evaluations to develop a perfect and personalized plan, [ 22 ] so the overall effect is not satisfactory, and it is urgent to develop family-based pulmonary rehabilitation methods. [ 23 ] Baduanjin is the representative of the traditional Chinese medicine guidance method, covering endurance training, breathing muscle training, stretching training, and psychological adjustment required for pulmonary rehabilitation. The whole set of movements is easy to learn, moderate intensity, and significant efficacy, which applicability and cost are much better than traditional pulmonary rehabilitation.…”

Delivering pulmonary rehabilitation during the COVID-19 pandemic: A Canadian Thoracic Society position statement

“…There are a number of ways to offer PR remotely to either eliminate or substantially decrease the risk of SARS-CoV-2 infection associated with in-person delivery models. There is growing evidence to support the use of home-based [6][7][8][9][10] and real time, on-line supervised telerehabilitation. 9 A group of Canadian clinicians and researchers have developed a standardized PR program, which has been endorsed by the CTS.…”

“…There is growing evidence to support the use of home-based [6][7][8][9][10] and real time, on-line supervised telerehabilitation. 9 A group of Canadian clinicians and researchers have developed a standardized PR program, which has been endorsed by the CTS. 11 This PR program was adapted from the Living Well with COPD program and focuses on disease self-management, and can be delivered in-person or through web-based platforms (including at home).…”