Tele-Pulmonary Rehabilitation Is As Effective As In-person
Background
Telehealth appointments and programs developed in response to the COVID-19 pandemic. This approach led to an opportunity to provide pulmonary rehabilitation using virtual instructions via the internet and telephone calls. Tele-Pulmonary Rehabilitation is the delivery of services at a distance making use of information and communication techniques.
Patient exercising at home supervised by therapist via Zoom
Study
Dr. Narelle S. Cox and colleagues from Melbourne, Australia, compared outocmes with home-based (telehealth) versus center-based (at hospital) pulmonary rehabilitation. The investigators analyzed results from two different studies.
All programs lasted 8 weeks. For center-based rehabilitation, patients attended two in-person sessions per week. Home-based programs included an initial visit at the patient’s home by a physiotherapist. For one program, there were two sessions per week using video with real time supervision of exercise. For the other program, there were seven once-weekly telephone calls to discuss improvements in exercise tolerance and goal setting.
All participants received printed and on-line sslf-management education resources provided by the Lung Foundation Australia.
Results
A total of 266 participants with COPD were included in the analyses. The proportion of responders (improved by a minimal clinical important difference) on the six minute walk test, health-related quality of life, and shortness of breath (modified Medical Research Council scale) was similar between home-based (tele) and center-based (hospital) at the end of the program (8 weeks) and at the 12 month follow-up. The risk of not completing the program was nealy FOUR times greater for those in the center-based program compared with tele-Pulmonary Rehabilitation (home-based).
Group exercise sessions at patient’s home monitored by Zoom
Conclusions
The proportion of RESPONDERS was similar between home-based versus center-based pulmonary rehabilitation.
My Comments
The benefits of pulmonary rehabilitation are well established - less shortness of breath, improved quality of life, enhanced ability to perform physical activities, and a reduced risk of a flare-up (exacerbation). The findings in this study support the opportunity to do pulmonary rehabilitation at home with supervision/monitoring by a rehabilitation specialist. These results are quite encouraging.
If you can not or do not want to attend an in-person program, consider a home-based exercise and education program. Some hospitals or clinics may offer tele-Pulmonary Rehabilitation or you may wish to search the internet for a program that is likely covered by your health insurance. More information is also available on the link from the American Thoracic Society.