Remote Pulmonary Rehab Brings ‘Similar Enhancements’ to In-Person Program

Key points to remember:

• Attendance and dropout rates for in-person and virtual rehabilitation centers were comparable.
• After rehab, both groups had better health-related quality of life, as measured by a survey.

According to a research letter published in CHEST.

Michael K. Stickland

“This study demonstrates that we can conduct pulmonary rehabilitation at home using video conferencing (i.e. Zoom) and show similar improvements to standard in-person rehab,” Michael K. Stickland, PhD, professor in the division of pulmonary medicine at the University of Alberta, Healio said. “Thanks to this work, our virtual program has been adopted as an operational program. Patients can now choose to come for rehab in person or do it virtually at home.”

In an observational cohort study, Stickland and colleagues analyzed 171 patients (mean age, 68 years; 50% female) receiving virtual pulmonary rehabilitation and 383 patients (mean age, 67 years; 41% female) receiving the program in person to assess the differences. in the results of the two modes of delivery.

The number of sessions was the same in both programs (16 sessions), and the researchers noted that group education and supervised exercise were a repeated feature.

To track changes in health-related quality of life, researchers asked patients to complete the COPD Assessment Test (CAT). They also compared changes in 6-minute walk distance (6MWD) after rehabilitation.

In this analysis, the most common disease classification was COPD in the in-person (73%) and virtual (66%) program.

Both groups showed similar adherence rates, which were measured by attendance and dropout (< nine sessions), and had improved CAT scores. Notably, those attending rehab remotely compared to those in person showed less improvement in health-related quality of life, which may be due to isolation requirements put in place during the pandemic. , the researchers wrote.

Although in-person patients had greater 6MWD at baseline compared to virtual patients (377m vs 332m; P < 0.001), the researchers found that the virtual patients had a significantly greater change from baseline to after rehabilitation (+68m vs. +35m), signaling better "functional exercise tolerance". It should be noted that this result was based on only two measurements of 6MWD: one before remote rehab and one after remote rehab, whereas the in-person group performed three tests before and after, according to the researchers.

Additionally, patients in the virtual rehabilitation group reported no adverse events.

“We were really happy to see that there was no increase in adverse events with the virtual program,” Stickland told Healio. “As clinicians, we’re always a bit worried that home rehabilitation might lead to bigger falls etc., but we haven’t seen any evidence of that.”

To find out if there was an association between various baseline characteristics and quitting among patients undergoing long-term drug treatment (n = 36), the researchers used logistic regression models. This evaluation found no relationship between baseline data/data combination and dropout.

“For our next steps, we are looking to integrate daily patient monitoring to obtain patient data, such as symptoms and SpO₂so that we can better detect when patients might need additional help to prevent an exacerbation of their COPD,” Stickland said.

For more information:

Michael K. Stickland, PhD, can be attached to [email protected].

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