Telerehabilitation in people with chronic obstructive pulmonary disease (COPD): A randomised controlled trial

Background: Home-based telerehabilitation (delivery of rehabilitation via desktop videoconferencing) has the potential to overcome the barriers that exist in accessing centre-based pulmonary rehabilitation programs. Aim: To determine the effectiveness of telerehabilitation on exercise capacity, self-efficacy and quality of life in people with COPD compared to no pulmonary rehabilitation. Methods: People with COPD were randomised to either a supervised home-based telerehabilitation group that received exercise training including cycling, walking and lower limb strengthening exercises, three times a week for eight weeks, or a control group that received usual medical care and did not participate in pulmonary rehabilitation. Exercise capacity was measured by the endurance shuttle walk test (ESWT), self-efficacy by the Pulmonary Rehabilitation Adapted Index of Self-Efficacy (PRAISE) tool and quality of life by the Chronic Respiratory Disease Questionnaire (CRDQ) at baseline and immediately post-intervention. Results: Thirty-six out of 37 participants (mean ± SD age 74 ± 8 years, FEV₁ 64 ± 21% predicted) completed the study. Compared to the control group, the telerehabilitation group significantly increased in the ESWT time (mean difference 340 seconds (95% CI 153 to 526, p<0.001)), PRAISE score (mean difference 8 points (95% CI 2 to 14, p<0.007)) and showed a trend towards a significant increase in the total score of the CRDQ (mean difference 8 points (95% CI -1 to 16, p=0.07)). Conclusion: Telerehabilitation is an effective therapy to improve endurance exercise capacity and self-efficacy in people with COPD.