Tele-Rehabilitation Program in Idiopathic Pulmonary Fibrosis—A Single-Center Randomized Trial

Cerdán-de-las-Heras, Jose; Balbino, Fernanda; Løkke, Anders; Catalán-Matamoros, Daniel; Hilberg, Ole; Bendstrup, Elisabeth

doi:10.3390/ijerph181910016

Cited by 35 publications

(72 citation statements)

References 27 publications

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“… The multifaceted VAPA platform and its digital environment (from Cerdan et al [ 27 ]) ( Figure 1 is taken from the paper “Tele-Rehabilitation Program in Idiopathic Pulmonary Fibrosis—A Single-Center Randomized Trial by Cerdan-de-las-heras et al [ 27 ], used under CC BY [ 28 ]/content modified from original). …”

Section: Figurementioning

confidence: 99%

Effect of a New Tele-Rehabilitation Program versus Standard Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

Cerdán-de-las-Heras

Balbino²,

Løkke

et al. 2021

JCM

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In chronic obstructive pulmonary disease (COPD), rehabilitation is recommended, but attendance rates are low. Tele-rehabilitation may be key. We evaluate the effect of a tele-rehabilitation program vs. standard rehabilitation on COPD. A randomized, non-inferiority study comparing eight weeks of tele-rehabilitation (physiotherapist video/chat-consultations and workout sessions with a virtual-autonomous-physiotherapist-agent (VAPA)) and standard rehabilitation in stable patients with COPD. At baseline, after 8 weeks and 3 and 6 months of follow-up, 6 min walk test distance (6MWTD), 7-day pedometry, quality of life, exercise tolerance, adherence, patient satisfaction and safety were assessed. Fifty-four patients (70 ± 9 years, male 57%, FEV1% 34.53 ± 11.67, FVC% 68.8 ± 18.81, 6MWT 376.23 ± 92.02) were included. Twenty-seven patients were randomized to tele-rehabilitation. Non-inferiority in Δ6MWTD at 8 weeks (47.4 ± 31.4), and at 3 (56.0 ± 38.0) and 6 (95.2 ± 47.1) months follow-up, was observed. No significant difference was observed in 7-day pedometry or quality of life. In the intervention group, 6MWTD increased by 25% and 66% at 3 and 6 months, respectively; adherence was 81%; and patient satisfaction was 4.27 ± 0.77 (Likert scale 0–5). Non-inferiority between groups and high adherence, patient satisfaction and safety in the intervention group were found after rehabilitation and at 3 and 6 months of follow-up. Tele-rehabilitation with VAPA seems to be a promising alternative.

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Section: Figurementioning

confidence: 99%

Effect of a New Tele-Rehabilitation Program versus Standard Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

Cerdán-de-las-Heras

Balbino²,

Løkke

et al. 2021

JCM

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“…The main characteristics of these eleven trials [14][15][16][17][18][19][20][21][22][23][24][25] are presented in Table 1a. These were published between 2008 and 2021 in seven countries, namely, the United States of America, China, Germany, Israel, Denmark, Japan, and Poland, with five studies performed in middle-high income countries and six in high-income countries.…”

Section: Resultsmentioning

confidence: 99%

“…The duration of pulmonary rehabilitation ranged from 3 weeks to 6 months, and six studies 15,16,18,19,23,24 reported the follow-up time points from 3 to 6 months. Eight studies [14][15][16]18,[20][21][22]24 were in an outpatient setting and all studies were completed under the supervision of the researchers. The severity of idiopathic pulmonary fibrosis ranged from mild to moderate in most studies.…”

Section: Resultsmentioning

confidence: 99%

“…The severity of idiopathic pulmonary fibrosis ranged from mild to moderate in most studies. In addition, all studies [14][15][16][17][18][19][20][21][22][23][24][25] reported the frequency of pulmonary rehabilitation, four studies reported the applications of oxygen therapy, [14][15][16]18 and four studies [14][15][16]21 reported the intensity of exercise. The characteristics of the pulmonary rehabilitation programs are provided in Table 1b.…”

Section: Resultsmentioning

confidence: 99%

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Clinical evidence for improving exercise tolerance and quality of life with pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis: A systematic review and meta-analysis

Lei

Xie

et al. 2022

Clin Rehabil

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Objective To evaluate the efficacy and safety of pulmonary rehabilitation for exercise tolerance and quality of life improvement in idiopathic pulmonary fibrosis. Methods We searched PubMed, Cochrane Library, Embase, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Database, and Chongqing VIP for randomized controlled trials that compared pulmonary rehabilitation with usual care for idiopathic pulmonary fibrosis. The risk of bias and certainty of evidence were assessed using Cochrane Collaboration’s Risk of Bias tool and the Grading of Recommendations, Assessment, Development and Evaluation criteria. Results Eleven trials in total with 549 participants. Compared with usual care, pulmonary rehabilitation significantly increased 6-minute walking distance (mean difference: 35.2m, 95% confidence intervals: 25.4m–44.9m; ten trials; 447 participants; moderate), decreased the St George's Respiratory Questionnaire total scores (mean difference: −9.11, 95% confidence intervals: −10.78 to −7.43; six trials; 303 participants; moderate), and reduced the modified Medical Research Council scores were lower (mean difference: −0.76, 95% confidence intervals: −1.25 to −0.27; three trials; 196 participants; low). Improvements were noted in forced vital capacity percent-predicted (mean difference: 4.88, 95% confidence intervals: 2.67 to 7.10; four trials; 214 participants; moderate) and diffusing capacity for carbon monoxide (mean difference: 4.71, 95% confidence intervals: 0.96 to 8.46; six trials; 358 participants; low). Conclusions Pulmonary rehabilitation may significantly improve exercise tolerance and quality of life in idiopathic pulmonary fibrosis patients, but the quality of evidence was low to moderate. Large sample, multicenter, randomized controlled trials are needed to verify the efficacy and safety of pulmonary rehabilitation.

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“…A randomized trial of 3 months of tele-PR among 29 individuals with IPF with remotely delivered physical therapy sessions demonstrated better maintenance of the 6MWD over 6 months in the tele-PR group compared to the control group. No significant difference was found between groups for pedometer-measured steps per day [ 104 ]. Adherence to the intervention was 64% over the first 3 months; no adverse events were recorded.…”

Section: Limitations Of Evidence Regarding Telehealth Interventions T...mentioning

confidence: 99%

Does Telemedicine Promote Physical Activity?

Rochester

2022

Life

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Exercise capacity and physical activity are different concepts: the former refers to what an individual is capable of performing, while the latter refers to what the individual does in daily life. Low levels of physical activity (PA), which are very common in individuals with COPD, are associated with poor health outcomes, including increased symptoms, a more rapid decline in lung function, increased health care utilization and increased mortality risk. Because of these pervasive negative outcomes, attempts have been made to increase physical activity in individuals with COPD, hoping that success in this area will mitigate the negative effects of inactivity. Based on its ability to increase exercise capacity and reduce dyspnea in COPD and other chronic respiratory diseases, pulmonary rehabilitation (PR) would be expected also increase physical activity in these patients. However, accessibility to pulmonary rehabilitation programs is problematic in some areas, and studies testing its effectiveness in this outcome area have had inconsistent results. Using telehealth interventions using technology to provide medical care conveniently over a distance would have the benefit of reaching a larger proportion of individuals with COPD. A systematic review of clinical trials testing telehealth to promote physical activity had mixed results and low-certainty evidence, resulting in the inability to recommend any single type of intervention. Thus, using telehealth interventions to promote physical activity for individuals with chronic respiratory diseases, while promising, remains an area where future investigations are needed to identify its optimal modalities and clarify its benefits.

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Tele-Rehabilitation Program in Idiopathic Pulmonary Fibrosis—A Single-Center Randomized Trial

Cited by 35 publications

References 27 publications

Effect of a New Tele-Rehabilitation Program versus Standard Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

Effect of a New Tele-Rehabilitation Program versus Standard Rehabilitation in Patients with Chronic Obstructive Pulmonary Disease

Clinical evidence for improving exercise tolerance and quality of life with pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis: A systematic review and meta-analysis

Does Telemedicine Promote Physical Activity?

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