Telerehabilitation in Subjects With Respiratory Disease: A Scoping Review

Abstract

Considering the current coronavirus disease (COVID-19) pandemic, telerehabilitation may be a viable first-line option for patients with respiratory tract disease. To date, there has been no systematic review on telerehabilitation for respiratory tract diseases, including COVID-19. Therefore, this scoping review aimed to determine what telerehabilitation for patients with respiratory tract diseases consists of, how safe telerehabilitation is for patients with respiratory tract diseases, and how feasible telerehabilitation is for hospitalized patients with COVID-19. In May 2020, we conducted a search of the following publication databases on the use of telerehabilitation in the treatment of respiratory tract diseases: Medical Literature Analysis and Retrieval System Online, Embase, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Literature, and Physiotherapy Evidence Database. Of the 208 articles identified, 23 studies were subsequently included in this scoping review. In 22 of the included studies, subjects had stable COPD and underwent telerehabilitation at home. The final included study was a case series of subjects with severe acute respiratory syndrome coronavirus 2 infection who underwent telerehabilitation in-hospital. Most telerehabilitation programs consisted of aerobic exercises using a cycle ergometer or a treadmill, walking, and muscle-strengthening exercises. The reported number of adverse events was low, and most studies reported that the average session adherence rate was > 70%. The majority of the telerehabilitation programs included a faceto-face rehabilitation assessment. Our findings indicate that, in its current state, telerehabilitation may be safe and feasible and may lead to reduced face-to-face rehabilitation therapy; in addition, remote rehabilitation assessment should be considered during the COVID-19 pandemic. Further research that targets a more diverse range of respiratory tract diseases and considers telerehabilitation in a hospital setting is required.

Future Challenges for Physical Therapy during and after the COVID-19 Pandemic: A Qualitative Study on the Experience of Physical Therapists in Spain

“…Conversely, the facilitators for telerehabilitation include less travel time for patients, ease of use of the system and a shorter waiting period for patients [48]. Taito et al [49] in their paper on telerehabilitation in patients with respiratory disease during the pandemic, described how the reported number of adverse events was low and the average treatment compliance rate was greater than 70%. In the Netherlands, Bos et al [48] showed positive results after using telemedicine for patients with rheumatic and musculoskeletal diseases during the COVID-19 pandemic.…”

Telemedicine as a Means to an End, Not an End in Itself

“…However, in general, positive results are demonstrated in emergency room admissions, exacerbation-related readmissions, early detection of acute exacerbation of COPD, and health-related outcomes [25][26][27][28][29][30][31][32][33][34][35][36]. Additionally, a review of tele-rehabilitation papers showed similar, favorable outcomes compared to standard, center-based pulmonary rehabilitation in functional exercise capacity, health related quality of life, and dyspnea [37][38][39][40][41]. Both interventions were safe and tele-rehabilitation patients were more likely to complete the program.…”

“…Exercise capacity (6 min walk test), St George's Respiratory Questionnaire (SGRQ), breathlessness on the Chronic Respiratory Questionnaire (CRQ) dyspnea domain score [38] Cardiopulmonary diseases Exercise capacity (6 min walk test), peak oxygen consumption, quality of life [39] Respiratory diseases Safety Feasibility Reduced face-to-face rehabilitation therapy [38,40] Respiratory diseases Assessment of sit-to-stand tests, Timed Up and Go step test, 6 min walk test (not for patients at risk of desaturation)…”

Clinical effectiveness and components of Home-pulmonary rehabilitation for people with chronic respiratory diseases: a systematic review protocol

“…34 Taito et al in a scoping review also included people recovering from COVID-19. 35 A recently published Cochrane review assessed the effectiveness and safety of telerehabilitation for people with CRDs when compared with Centre-PR or no rehabilitation 36 and concluded that primary or maintenance PR telerehabilitation achieved similar outcomes to Centre-PR. In this review, remote delivery of PR was defined by the use of telecommunications technology to deliver PR services to individuals or groups (either physical or virtual) in any location, including in the patient's home or at a healthcare centre.…”

“…In contrast, in our review, the definition of Home-PR is that the sessions are undertaken by an individual by themselves (though a family member may be involved) and typically at home. Apart from baseline and post-PR assessments, 35 the patient does not attend a centre (either a hospital centre or a local ‘satellite’ centre) and is not supervised face-to-face by a healthcare professional (though there may be remote communication from a healthcare professional for some or all of the session).…”