Benefits of Telemonitoring of Pulmonary Function—3-Month Follow-Up of Home Electronic Spirometry in Patients with Duchenne Muscular Dystrophy

Abstract

Background: In patients with Duchenne Muscular Dystrophy (DMD), the respiratory system determines the quality and length of life; therefore, the search for easy and safe everyday monitoring of the pulmonary function is currently extremely important, particularly in the COVID-19 pandemic. The aim of the study was to evaluate the influence of a three-month home electronic spirometry (e-spirometry) monitoring of the pulmonary function and strength of respiratory muscles as well as the patients’ benefits from this telemetric program. Methods: Twenty-one boys with DMD (aged 7–22; non-ambulatory-11) received a remote electronic spirometer for home use with a special application dedicated for patients and connected with a doctor platform. Control of the hospital spirometry (forced vital capacity-FVC, forced expiratory volume in 1 second-FEV1, peak expiratory flow-PEF) and respiratory muscle strength (maximal inspiratory-MIP and expiratory pressures-MEP) before and after the three-month monitoring were performed as well telemonitoring benefit survey. Results: A total of 1403 measurements were performed; 15 of the participants were able to achieve correct attempts. There were no differences between the hospital and the home spirometry results as well as between respiratory muscle strength during v1 vs. v2 visits for the whole study group (all parameters p > 0.05); the six participants achieved increased value of FVC during the study period. There was a positive correlation between ΔFVC and the number of assessments during the home spirometry (r = 0.7, p < 0.001). Differences between FVC and MIPcmH2O (r = 0.58; p = 0.01), MEPcmH2O (r = 0.75; p < 0.001) was revealed. The mean general satisfaction rating of the telemonitoring was 4.46/5 (SD 0.66) after one month and 4.91/5 (SD 0.28) after three months. The most reported benefit of the home monitoring was the improvement in breathing (38% of participants after one month, 52% after three months of telemonitoring). Forgetting about the procedures was the most common reason for irregular measurements; the participants reported also increased motivation but less time to perform tests. Conclusions: The study indicates high compliance of the home telemonitoring results with the examination in the hospital. Benefits from home spirometry were visible for all participants; the most important benefit was breathing improvement. The remote home spirometry is usable for everyday monitoring of the pulmonary function in DMD patients as well can be also treated as respiratory muscle training.

A Pervasive Pulmonary Function Estimation System with Six-Minute Walking Test

“…A home-based mobile spirometer was a tool for self-monitoring in daily pulmonary function at home for Duchenne Muscular Dystrophy (DMD) and the detecting progression in idiopathic pulmonary fibrosis (IPF). However, it took a while for the training to use the device [ 32 , 33 ]. A home-based mobile spirometer was also used to reduce the frequency of acute exacerbation of COPD [ 34 ].…”

“…A home-based mobile spirometer was also used to reduce the frequency of acute exacerbation of COPD [ 34 ]. Piotr et al reported 10,936 spirometries in 9855 patients were performed by 673 primary care professionals with a mobile phone-linked portable device, showed 5347 (49%) spirometry examinations met both accuracy and repeatability criteria [ 32 ]. There may be more performance plateau errors for self-using in the general population.…”

The Association between the Respiratory System and Upper Limb Strength in Males with Duchenne Muscular Dystrophy: A New Field for Intervention?

“…However, taking into account our previous study, “E-monitoring of PULMonary function in patients with Duchenne Muscular Dystrophy at home,” (E-PULMoDMD; ClinicalTrials.gov Identifier: NCT05516745), was determined that daily regular spirometry measurements at home increase the quality and repeatability of the results obtained in the clinic and improve respiratory comfort, in some patients [ 35 ]. To improve the quality of the results obtained and to achieve greater repeatability, perhaps it should be recommended to perform more frequent measurements than those currently recommended (every 6–12 months) [ 36 ], especially since there are portable devices which can be used in homes [ 37 , 38 ].…”

“…Our previous study showed that it is possible to implement the telerehabilitation of respiratory muscles in patients with DMD [ 37 , 38 ]. After the results of the current research, we now consider the concept of the combined rehabilitation of both the respiratory system and the upper limbs.…”

Satisfaction with pediatric telehealth according to the opinions of children and adolescents during the COVID-19 pandemic: A literature review

“…The Supplementary file S2 Figure illustrates the flow of selecting articles. The number of final studies included in this review was 14 (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). An example of a study that was excluded during the full-text review was the study of Elbin et al, 2022 (33) on the satisfaction with telehealth among adolescents prior to the pandemic.…”