Telerehabilitation in pulmonary diseases

Abstract

Purpose of reviewTelerehabilitation is an alternative delivery model for pulmonary rehabilitation, an evidence-based nonpharmacological intervention, in people with chronic pulmonary disease. This review synthesizes current evidence regarding the telerehabilitation model for pulmonary rehabilitation with an emphasis on its potential and implementation challenges, as well as the clinical experiences from the COVID-19 pandemic.Recent findingsDifferent models of telerehabilitation for delivering pulmonary rehabilitation exist. Current studies comparing telerehabilitation to centre-based pulmonary rehabilitation primarily focus on the evaluation in people with stable chronic obstructive pulmonary disease, which demonstrated equivalent improvements in exercise capacity, health-related quality of life and symptoms with improved programme completion rates. Although telerehabilitation may improve access to pulmonary rehabilitation by addressing travel burden, improving schedule flexibility and geographic disparity, there are challenges of ensuring satisfaction of healthcare interactions and delivering core components of initial patient assessment and exercise prescription remotely.SummaryFurther evidence is needed on the role of telerehabilitation in various chronic pulmonary diseases, as well as the effectiveness of different modalities in delivering telerehabilitation programmes. Economic and implementation evaluation of currently available and emerging models of telerehabilitation in delivering pulmonary rehabilitation are needed to ensure sustainable adoption into clinical management for people with chronic pulmonary disease.

From illness management to quality of life: rethinking consumer health informatics opportunities for progressive, potentially fatal illnesses

“…Pulmonary rehab programs have been adapted to incorporate leisure activities as a way to target social isolation 145 and delivered by palliative multidisciplinary care teams who are trained in providing support to people throughout all stages of COPD progression. 128 The proliferation of teleconferencing tools during the past 3 years 37 , 146 offers a way to reach patients who previously were denied access—those who lack transportation access, have limited social support, currently smoke, or fear viral infection. 37–40 , 147…”

Client and clinician perspectives about a virtual education and exercise chronic disease management programme for people with hip and knee osteoarthritis

“…Although advantages and challenges of virtual care and programs have been previously reported in other populations and settings (Cox & Khor, 2023; Grundstein, Fisher, Titmuss, & Cioppa‐Mosca, 2021; Lee, Breznen, Ukhova, Koehler, & Martin, 2023), this study specifically recruited individuals involved with the GLA:D TM Canada remote programme and therefore findings may not transfer to other virtual education and exercise programs or contexts. Multiple and sustained recruitment strategies were used to obtain a representative sample from across Canada; however, most of the sample was comprised of individuals living and practicing in Central Canada.…”

“…Although advantages and challenges of virtual care and programs have been previously reported in other populations and settings (Cox & Khor, 2023;Grundstein, Fisher, Titmuss, & Cioppa-Mosca, 2021;Lee, Breznen, Ukhova, Koehler, & Martin, 2023) Patient engagement has demonstrated improved priority setting, collaborative analysis of results, and ultimately research that better aligns with patient needs and values (Duffett, 2017). While we undertook several methods to enhance rigour, validity, and credibility of the findings, including prolonged engagement with data, peer debriefing, clarifying our bias, and completing the analysis by subgroup prior to combining, and presenting divergent cases (Cresswell & Cresswell, 2018b), we did not use member checking (Nowell et al, 2017).…”

The lung way home: ready for home monitoring in lung diseases?

“…1). This was not only emphasized in the reviews on specific lung diseases, but also nicely illustrated in the review of Cox and Khor, which focused on telerehabilitation in chronic lung diseases [11]. As face-to-face pulmonary rehabilitation was restricted, telerehabilitation was widely embraced, with up to 75% of centers offering an online program within 6 months after the start of the pandemic.…”

“…This issue of Current Opinion in Pulmonary Medicine provides a state-of-the-art on home monitoring in chronic obstructive pulmonary disease (COPD), asthma, cystic fibrosis (CF), interstitial lung disease (ILD), and COVID-19, as well as novel insights into telerehabilitation, digital outcome measures, and implementation barriers [5][6][7][8][9][10][11][12]. Although home monitoring seems to be feasible across pulmonary medicine, data on clinical efficacy and cost-effectiveness are not unequivocally positive.…”