Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial

Chaplin, Emma; Hewitt, Stacey; Apps, Lindsay; Bankart, John; Pulikottil-Jacob, Ruth; Boyce, Sally; Morgan, Mike; Williams, JE; Singh, Sally

doi:10.1136/bmjopen-2016-013682

Cited by 104 publications

(179 citation statements)

References 38 publications

Supporting

Mentioning

175

Contrasting

Unclassified

Order By: Relevance

“…12 To date, two randomised controlled trials (RCTs) have explored the effect of unsupervised web-based or video-demonstrated individual exercise and education compared with conventional group-based PR in patients with stable moderateto-severe COPD. 13 14 The studies did not find differences between interventions for outcomes of walking capacity and respiratory symptoms. 13 14…”

Section: Introductionmentioning

confidence: 91%

Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: a randomised multicentre trial

Hansen

Bieler

Beyer

et al. 2020

Thorax

188

249

View full text Add to dashboard Cite

RationalePulmonary rehabilitation (PR) is an effective, key standard treatment for people with COPD. Nevertheless, low participant uptake, insufficient attendance and high drop-out rates are reported. Investigation is warranted of the benefits achieved through alternative approaches, such as pulmonary tele-rehabilitation (PTR).ObjectiveTo investigate whether PTR is superior to conventional PR on 6 min walk distance (6MWD) and secondarily on respiratory symptoms, quality of life, physical activity and lower limb muscle function in patients with COPD and FEV1 <50% eligible for routine hospital-based, outpatient PR.MethodsIn this single-blinded, multicentre, superiority randomised controlled trial, patients were assigned 1:1 to 10 weeks of groups-based PTR (60 min, three times weekly) or conventional PR (90 min, two times weekly). Assessments were performed by blinded assessors at baseline, end of intervention and at 22 weeks’ follow-up from baseline. The primary analysis was based on the intention-to-treat principle.Measurements and main resultsThe primary outcome was change in 6MWD from baseline to 10 weeks; 134 participants (74 females, mean±SD age 68±9 years, FEV1 33%±9% predicted, 6MWD 327±103 metres) were included and randomised. The analysis showed no between-group differences for changes in 6MWD after intervention (9.2 metres (95% CI: −6.6 to 24.9)) or at 22 weeks’ follow-up (−5.3 metres (95% CI: −28.9 to 18.3)). More participants completed the PTR intervention (n=57) than conventional PR (n=43) (χ2 test p<0.01).ConclusionPTR was not superior to conventional PR on the 6MWD and we found no differences between groups. As more participants completed PTR, supervised PTR would be relevant to compare with conventional PR in a non-inferiority design.Trial registration numberClinicalTrials.gov (NCT02667171), 28 January 2016.

show abstract

Section: Introductionmentioning

confidence: 91%

Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: a randomised multicentre trial

Hansen

Bieler

Beyer

et al. 2020

Thorax

188

249

View full text Add to dashboard Cite

show abstract

“…Smaller feasibility trials have been conducted to better understand the acceptability and uptake of digital‐based solutions. To date, they have not been of adequate sample size to conclude they are non‐inferior; however, there have been some encouraging results . These web‐based programmes have been delivered remotely, but may have included facilities allowing individuals to contact healthcare professionals remotely for personal advice.…”

Section: Pulmonary Rehabilitation In Copdmentioning

confidence: 99%

Pulmonary rehabilitation for obstructive lung disease

Osadnik

Singh

2019

Respirology

Self Cite

View full text Add to dashboard Cite

Pulmonary rehabilitation (PR) is a highly effective, established therapy to improve exercise intolerance, impaired quality of life and limb muscle weakness associated with a range of chronic respiratory diseases. The evidence base for PR is largest in the area of chronic obstructive pulmonary disease (COPD), yet its role in other obstructive lung diseases such as asthma is less well defined. Despite several features being common across both COPD and asthma, factors such as younger age or employment may affect the potential applicability of traditional PR models for patients with asthma. This review examines the current evidence regarding PR for the obstructive lung diseases of COPD and asthma. It offers appraisal of some of the strengths and weaknesses of existing literature, identifies areas in need of future research and details some of the issues facing clinicians responsible for the clinical management and rehabilitation of patients with these diseases.

show abstract

“…All these interventions, particularly if they show effects, may have a place in the care of patients with chronic respiratory conditions, but it is not helpful to move the field forward if they are branded as ‘rehabilitation’ or proposed as alternatives for pulmonary rehabilitation . In the past few years, internet‐based self‐management programmes, home‐based minimally supervised rehabilitation, tai chi exercises and yoga have all been proposed as alternatives for pulmonary rehabilitation. While these interventions may have a place in the management of some patients with chronic respiratory diseases, or may be the only alternatives in specific regions, it should be clear that these interventions are no substitute for pulmonary rehabilitation.…”

Section: The Future Of Pulmonary Rehabilitationmentioning

confidence: 99%

The past, present and future of pulmonary rehabilitation

et al. 2019

View full text Add to dashboard Cite

Abundant evidence supports the use of pulmonary rehabilitation as a treatment for stable and exacerbated chronic obstructive pulmonary disease. Several questions around the science base of rehabilitation in other patient groups as well as the role of rehabilitation as a component in other comprehensive care trajectories remain to be addressed. The impact of a rehabilitation programme could also perhaps be enhanced if clear guidance would be available on how to individualize the components of a rehabilitation programme in individual patients. The rehabilitation community, in an attempt to increase access to programmes, has developed less rigorous interventions. These may serve specific patients (e.g. less severe patients or may be used as a maintenance programme), but in order to have conceptual clarity they should not be called substitutes for rehabilitation if they do not meet the definition of rehabilitation. Reaching clarity on the best format for maintenance programmes in order to achieve long-lasting health benefits for patients is another challenge. Furthermore, as many patients as possible should be referred to adequate rehabilitation programmes within their reach with fair reimbursement. Programmes should take into account the burden of the disease of a patient, the required components to tackle the problems, adequate assessment to document the outcome and the patient's preference. In summary, pulmonary rehabilitation is one of the most potent evidence-based therapies for patients with respiratory diseases. Researchers should continue to fine tune the interventions, get clarity on terminology as well as the ultimate outcomes for rehabilitation to ensure sustainable health effects.

show abstract

Interactive web-based pulmonary rehabilitation programme: a randomised controlled feasibility trial

Cited by 104 publications

References 38 publications

Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: a randomised multicentre trial

Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: a randomised multicentre trial

Pulmonary rehabilitation for obstructive lung disease

The past, present and future of pulmonary rehabilitation

Contact Info

Product

Resources

About