The efficacy of remote pulmonary rehabilitation in the management of interstitial lung disease

Pulmonary rehabilitation has been shown to be a safe intervention in those with interstitial lung disease, leading to improved quality of life in those with functional limitation. Traditionally, patients would attend a local rehabilitation class for up to eight weeks. The Covid-19 pandemic led to the development of a home exercise programme to minimise face-to-face contact. The efficacy of an 8 week remotely supervised rehabilitation programme between November 2021 and February 2022 was evaluated. This was a combination of aerobic and resistance training at home, the intensity of which was based on the reported fitness of the individual. A 6MWT and quality of life score were performed before and after training. This was compared to an 8-week in-person supervised programme, where patients attended thrice weekly. 6MWTs and QoL scores were performed before and after exercise training. 79 patients were enrolled in the HEP, of which 42 completed. Mean age was 68.9 years, with mean FEV1 75.6% and BMI 29. Pre rehabilitation mean 6MWT for HEP was 223.6m and post 254.4m (p=<0.01). QOL improved with a reduction in mean BORG from 2.3 to 2 (p=0.19). No adverse events were reported. In the supervised group, 556 completed, with mean age of 74years. Mean FEV1% 61.6 and BMI 27.7. Mean pre-training 6MWT 203.4m, post 256.3m (p=<0.01) and BORG pre 2.71, post 2.1 (p=0.19). Whilst HEP was shown to be safe and effective, supervised rehabilitation was shown to be more effective in this population. Supervised training has the added benefit of peer support, and health provider interventions, such as smoking cessation and lifestyle advice. HEP should be reserved for those unable to perform a supervised programme.