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- In-person and virtual rehab attendance and dropout rates were comparable.
- Following rehab, both groups had better health-related quality of life, measured through a survey.
Remote pulmonary rehabilitation during the COVID-19 pandemic demonstrated comparable outcomes to rehabilitation that took place in person prior to the pandemic, according to a research letter published in CHEST.
Michael K. Stickland
“This study demonstrates that we can conduct pulmonary rehab at home using videoconferencing (ie, Zoom) and show similar improvements as standard in-person rehab,” Michael K. Stickland, PhD, professor in the division of pulmonary medicine at the University of Alberta, told Healio. “Because of this work, our virtual program has been adopted as an operational program. Patients can now choose whether to come down and do in-person rehab or do it virtually in their homes.”
In an observational cohort study, Stickland and colleagues analyzed 171 patients (mean age, 68 years; 50% women) receiving pulmonary rehab virtually and 383 patients (mean age, 67 years; 41% women) receiving the program in-person to evaluate differences in outcomes of the two modes of delivery.
The number of sessions was the same in both programs (16 sessions), and researchers noted that group education and supervised exercise were a repeated feature.
To track changes in health-related quality of life, researchers had patients complete the COPD assessment test (CAT). They also compared changes in 6-minute walk distance (6MWD) after rehab.
In this analysis, the most common disease classification was COPD in both the in-person (73%) and virtual (66%) program.
Both groups showed similar rates of adherence, which was measured through attendance and dropout (< nine sessions), and had improved CAT scores. Notably, those attending rehab remotely vs. in-person showed less improvement in health-related quality of life, which may be due to isolation requirements put in place during the pandemic, the researchers wrote.
Although in-person patients had greater 6MWD at baseline vs. virtual patients (377 m vs. 332 m; P < .001), researchers found that virtual patients had a significantly larger change from baseline to after rehab (+ 68 m vs. + 35 m) signaling better “functional exercise tolerance.” It should be noted that this finding was based on only two measures of 6MWD: one before remote rehab and one after remote rehab, whereas the in-person group did three tests before and after, according to researchers.
Additionally, patients in the virtual rehab group did not report any adverse events.
“We were really happy to see that there were no increased adverse events with the virtual program,” Stickland told Healio. “As clinicians, we are always a bit worried that conducting rehab at home might lead to greater falls, etc, but we saw no evidence of this.”
To find out if there was a link between various baseline characteristics and dropout in patients attending rehab remotely (n = 36), researchers used logistic regression models. This assessment did not find a relationship between any baseline data/combination of data and dropout.
“For our next steps, we are looking to integrate daily patient monitoring to obtain patient data, like symptoms and SpO2, so that we can better detect when patients might be needing extra help to prevent an exacerbation of their COPD,” Stickland said.
For more information:
Michael K. Stickland, PhD, can be reached at [email protected].