Pulmonary rehabilitation in a postcoronavirus disease 2019 world: feasibility, challenges, and solutions

Wen, Jinyu; Milne, Stephen; Sin, Don D.

doi:10.1097/mcp.0000000000000832

Cited by 15 publications

(12 citation statements)

References 56 publications

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“…However, some participants reported difficulties with the technology, and there was a desire for in-person contacts. Future iterations of ReStOre could address this by using a hybrid model of service delivery to provide greater patient choice and to potentially increase recruitment [ 72 , 73 ].…”

Section: Discussionmentioning

confidence: 99%

Telehealth Delivery of a Multi-Disciplinary Rehabilitation Programme for Upper Gastro-Intestinal Cancer: ReStOre@Home Feasibility Study

Brennan

Sadeghi

O’Neill

et al. 2022

Cancers

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Background: Telehealth has enabled access to rehabilitation throughout the pandemic. We assessed the feasibility of delivering a multi-disciplinary, multi-component rehabilitation programme (ReStOre@Home) to cancer survivors via telehealth. Methods: This single-arm mixed methods feasibility study recruited participants who had completed curative treatment for oesophago-gastric cancer for a 12-week telehealth rehabilitation programme, involving group resistance training, remotely monitored aerobic training, one-to-one dietetic counselling, one-to-one support calls and group education. The primary outcome was feasibility, measured by recruitment rates, attendance, retention, incidents, acceptability, Telehealth Usability Questionnaire (TUQ) and analysis of semi-structured interviews. Results: Characteristics of the twelve participants were: 65.42 ± 7.24 years; 11 male; 10.8 ± 3.9 months post-op; BMI 25.61 ± 4.37; received neoadjuvant chemotherapy 7/12; received adjuvant chemotherapy 4/12; hospital length of stay 16 days (median). Recruitment rate was 32.4%, and retention rate was 75%. Mean attendance was: education 90%; dietetics 90%; support calls 84%; resistance training 78%. Mean TUQ score was 4.69/5. Adaptations to the planned resistance training programme were required. Participants reported that ReStOre@Home enhanced physical and psychological wellbeing, and online delivery was convenient. Some reported a preference for in-person contact but felt that the online group sessions provided adequate peer support. Conclusion: Telehealth delivery of ReStOre@Home was most feasible in individuals with moderate to high levels of digital skills. Low level of digitals skills was a barrier to recruitment and retention. Participants reported high levels of programme adherence and participant satisfaction. Adaptations to future programmes, including introducing elements of in-person contact, are required.

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Section: Discussionmentioning

confidence: 99%

Telehealth Delivery of a Multi-Disciplinary Rehabilitation Programme for Upper Gastro-Intestinal Cancer: ReStOre@Home Feasibility Study

Brennan

Sadeghi

O’Neill

et al. 2022

Cancers

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“…There are still many challenges and unanswered questions regarding patient and HCP adoption of digitally enabled PR [11,70]. However, recent work has begun to explore the implementation and adoption needs of patients and HCPs for digital health in the management of COPD, much of which is relevant to the design of digital PR interventions [71].…”

Section: A Barriers and Facilitators To Adoption: Patient Perspectivementioning

confidence: 99%

“…Research suggests that HCPs perceive the lack of evidence demonstrating the effectiveness of digital health interventions on patient outcomes as a salient barrier to them adopting this model of care [76]. Although digitally enabled PR has accelerated during the pandemic, there is agreement on the need for large-scale, longitudinal studies to demonstrate the cost and clinical effectiveness of digitally enabled PR [70,77]. Cardiac tele-rehabilitation, for instance, has developed a strong evidence-base, including a Cochrane review demonstrating that this model reduces re-hospitalisations and is equally cost-effective to standard rehabilitation programmes [78,79].…”

Section: B Barriers and Facilitators To Adoption: The Hcp Perspectivementioning

confidence: 99%

Role of digital health in pulmonary rehabilitation and beyond: shaping the future

et al. 2022

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Pulmonary rehabilitation (PR) is a cost-effective intervention with well-known benefits on exercise capacity, symptoms and quality of life in patients with chronic respiratory diseases. Despite the compelling evidence of its benefits, PR implementation is still suboptimal, and maintenance of PR benefits is challenging. To overcome these pitfalls, there has been a growing interest to develop novel models for PR delivery. Digital health is a promising solution, as it has the potential to address some of the most reported barriers to PR uptake and adherence (such as accessibility issues), help maintain the positive results following a PR programme, and/or promote patients’ adherence to a more active lifestyle through physical activity (tele-)coaching. Despite the accelerated use of digital health to deliver PR during the COVID-19 pandemic, there are still several factors that contribute to the resistance in the adoption of digital health, such as the lack of evidence on its effectiveness, low acceptability by patients and healthcare professionals, concerns about implementation and maintenance costs, inequalities in access to the internet and technological devices, and data protection issues. Nevertheless, the trend towards reducing technology costs and the higher availability of digital devices, as well as the greater ease and simplicity of use of devices, enhance the opportunities for future development of digitally enabled PR interventions. This narrative review aimed to examine the current evidence on the role of digital health in the context of PR, including strengths and weaknesses, and to determine possible threats and opportunities, as well as areas for future work.

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“…In this context, home-based PR programs may provide an easier, practical, less-costly, and effective alternative to in- and outpatient programs [ 13 , 14 ]. They were rapidly adopted during the COVID-19 pandemic to overcome many mobility restrictions, facilitate access, and reduce the healthcare system burden [ 15 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

Virtual pulmonary rehabilitation approaches in patients with post COVID syndrome: a pilot study

Sarmento,

Adodo,

Hodges

et al. 2024

BMC Pulm Med

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Background The characteristics of optimal virtual pulmonary rehabilitation (PR) for individuals with post-COVID syndrome (PCS) have not been identified. This study aimed to assess the feasibility, safety, and satisfaction associated with a virtual PR program with the exercise component delivered through group or self-directed sessions. Methods Adults with PCS-respiratory symptoms were randomly assigned to the video conference (PRVC) or self-directed (PRSD) group and completed an exercise program (aerobic, strengthening, and breathing exercises) three times/week for eight weeks. PRVC sessions were led by a physiotherapist via Zoom, whereas the PRSD group exercised individually following a pre-recorded video. Both groups received personalized exercise recommendations, education related to the condition, and a weekly follow up call. Satisfaction was assessed through a patient survey. Lung function, dyspnea, fatigue, sit-to-stand capacity, health-related quality of life, and participation were assessed pre- and post-PR. Results Fourteen PCS individuals (49 ± 9 years, 86% females) completed 83% of the sessions. All participants were satisfied with information provided by the therapist and frequency of data submission, whereas most were satisfied with the frequency and duration of exercise sessions (88% in PRVC and 83% in PRSD). A higher proportion of participants in the PRVC (88%) were satisfied with the level of difficulty of exercises compared with the PRSD (67%), and 84% of the sample reported a positive impact of the program on their health. No adverse events were reported. Significant changes in sit-to-stand capacity (p = 0.012, Cohen’s r = 0.67) and questions related to fatigue (p = 0.027, Cohen’s r = 0.58), neurocognitive (p = 0.045, Cohen’s r = 0.53), and autonomic (p = 0.024, Cohen’s r = 0.60) domains of the DePaul Symptom Questionnaire short-form were also found between groups. Conclusion Virtual PR with exercises delivered via video conference or pre-recorded video were feasible, safe, and well-received by individuals with PCS. Trial registration NCT05003271 (first posted: 12/08/2021).

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Pulmonary rehabilitation in a postcoronavirus disease 2019 world: feasibility, challenges, and solutions

Cited by 15 publications

References 56 publications

Telehealth Delivery of a Multi-Disciplinary Rehabilitation Programme for Upper Gastro-Intestinal Cancer: ReStOre@Home Feasibility Study

Telehealth Delivery of a Multi-Disciplinary Rehabilitation Programme for Upper Gastro-Intestinal Cancer: ReStOre@Home Feasibility Study

Role of digital health in pulmonary rehabilitation and beyond: shaping the future

Virtual pulmonary rehabilitation approaches in patients with post COVID syndrome: a pilot study

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