https://doi.org/10.4081/monaldi.2022.2105
Efficacy of respiratory tele-rehabilitation in COPD patients: Systematic review and meta-analysis
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 27 January 2022
Pulmonary rehabilitation (PR) is a proven and effective intervention for chronic obstructive pulmonary disease (COPD). The recent pandemic has raised interest on new services, such as telerehabilitation (Tele-R). The aim of this study was to systematically review the effects of Tele-R in COPD on: 1) exercise capacity evaluated by the 6-minute walk test (6MWT); 2) dyspnea (modified Medical Research Council – mMRC); 3) COPD control (the COPD assessment test - CAT). The analysis compared Tele-R versus no rehabilitation and Tele-R versus center-based rehabilitation. This meta-analysis was undertaken according to PRISMA recommendations. This pair-wise meta-analysis included data obtained from studies that enrolled 758 COPD patients. The tele-R compared to no rehabilitation improved the 6MWT distance of 48 m (CI: 24, 72; p<0.001) and the mMRC of -1.02U (CI: -1.49, -0.59; p<0.001), and the CAT of -5.74U (CI: -7.42, -0.407; p<0.001). The tele-R compared to center-based rehabilitation showed no difference on 6MWT distance (p=0.563), mMRC (p=0.911), and CAT (p=0.85). In COPD patients, Tele-R is effective in improving exercise tolerance and patient-reported outcomes and it seems to be a valid alternative to center-based rehabilitation, but more studies are needed to better understand how to select the right patients and which kind of Tele-R is more appropriate.
Downloads
Spruit MA, Singh SJ, Garvey C, et al. An Official American Thoracic Society/European Respiratory Society Statement: Key Concepts and Advances in Pulmonary Rehabilitation. Am J Respir Crit Care Med 2013;188:e13–e64. DOI: https://doi.org/10.1164/rccm.201308-1509ST
Lacasse Y, Martin S, Lasserson TJ, et al. Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease. A Cochrane systematic review. Eura Medicophys 2007;43:475-85. DOI: https://doi.org/10.1002/14651858.CD003793.pub2
Pitta F, Troosters T, Probst VS, et al. Are patients with COPD more active after pulmonary rehabilitation? Chest 2008;134:273–280. DOI: https://doi.org/10.1378/chest.07-2655
Rochester CL, Vogiatzis I, Holland AE, et al. An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation. Am J Respir Crit Care Med 2015;192:1373–86. DOI: https://doi.org/10.1164/rccm.201510-1966ST
Siddiq MAB, Rathore FA, Clegg D, et al. Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic. Turk J Phys Med Rehabil 2020;66:480–94. DOI: https://doi.org/10.5606/tftrd.2020.6889
Peretti A, Amenta F, Tayebati SK, et al. Telerehabilitation: Review of the state-of-the-art and areas of application. JMIR Rehabil Assist Technol 2017;4:e7. DOI: https://doi.org/10.2196/rehab.7511
Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097. DOI: https://doi.org/10.1371/journal.pmed.1000097
Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev 2015;4:1. DOI: https://doi.org/10.1186/2046-4053-4-1
Holland AE, Mahal A, Hill CJ, et al. Home-based rehabilitation for COPD using minimal resources: a randomised, controlled equivalence trial. Thorax 2017;72:57–65. DOI: https://doi.org/10.1136/thoraxjnl-2016-208514
Cox NS, Dal Corso S, Hansen H, et al. Telerehabilitation for chronic respiratory disease. Cochrane Database Syst Rev 2021;1:CD013040. DOI: https://doi.org/10.1002/14651858.CD013040.pub2
Pedder H, Sarri G, Keeney E, et al. Data extraction for complex meta-analysis (DECiMAL) guide. Syst Rev 2016;5:212. DOI: https://doi.org/10.1186/s13643-016-0368-4
Wallace BC, Dahabreh IJ, Trikalinos TA, et al. Closing the gap between methodologists and end-users: R as a computational back-end. J Stat Soft 2012;49:1-15. DOI: https://doi.org/10.18637/jss.v049.i05
Calzetta L, Rogliani P, Matera MG, et al. A systematic review with meta-analysis of dual bronchodilation with LAMA/LABA for the treatment of stable COPD. Chest 2016;149:118-96. DOI: https://doi.org/10.1016/j.chest.2016.02.646
Bernocchi P, Vitacca M, La Rovere MT, et al. Home-based telerehabilitation in older patients with chronic obstructive pulmonary disease and heart failure: a randomised controlled trial. Age Ageing 2018;47:82–8. DOI: https://doi.org/10.1093/ageing/afx146
Tabak M, Vollenbroek-Hutten MM, van der Valk PD, et al. A telerehabilitation intervention for patients with Chronic Obstructive Pulmonary Disease: a randomized controlled pilot trial. Clin Rehabil 2014;28:582–91. DOI: https://doi.org/10.1177/0269215513512495
Cameron-Tucker H, Wood-Baker R, Joseph L, et al. A randomized controlled trial of telephone-mentoring with home-based walking preceding rehabilitation in COPD. COPD 2016;11:1991-2000. DOI: https://doi.org/10.2147/COPD.S109820
Tsai LLY, McNamara RJ, Moddel C, et al. Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: The randomized controlled TeleR Study: Telerehabilitation in patients with COPD. Respirology 2017;22:699–707. DOI: https://doi.org/10.1111/resp.12966
Bourne S, DeVos R, North M, et al. Online versus face-to-face pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: randomised controlled trial. BMJ Open 2017;7:e014580. DOI: https://doi.org/10.1136/bmjopen-2016-014580
Hansen H, Bieler T, Beyer N, et al. Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: a randomised multicentre trial. Thorax 2020;75:413–21. DOI: https://doi.org/10.1136/thoraxjnl-2019-214246
Vasilopoulou M, Papaioannou AI, Kaltsakas G, et al. Home-based maintenance tele-rehabilitation reduces the risk for acute exacerbations of COPD, hospitalisations and emergency department visits. Eur Respir J 2017;49:1602129. DOI: https://doi.org/10.1183/13993003.02129-2016
Holland AE, Cox NS, Houchen-Wolloff L, et al. Defining modern pulmonary rehabilitation. An Official American Thoracic Society Workshop Report. Ann Am Thorac Soc 2021;18:e12–e29. DOI: https://doi.org/10.1513/AnnalsATS.202102-146ST
Puente-Maestu L, Palange P, Casaburi R, et al. Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement. Eur Respir J 2016;47:429–60. DOI: https://doi.org/10.1183/13993003.00745-2015
Dodd JW, Hogg L, Nolan J, et al. The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study. Thorax 2011;66:425–9. DOI: https://doi.org/10.1136/thx.2010.156372
Alison JA, McKeough ZJ, Johnston K, et al. Australian and New Zealand pulmonary rehabilitation guidelines. Respirology 2017;22:800-19. DOI: https://doi.org/10.1111/resp.13025
Güell M-R, Cejudo P, Ortega F, et al. Benefits of long-term pulmonary rehabilitation maintenance program in patients with severe chronic obstructive pulmonary disease. Three-year follow-up. Am J Respir Crit Care Med 2017;195:622–9. DOI: https://doi.org/10.1164/rccm.201603-0602OC
Barbosa MT, Sousa CS, Morais-Almeida M, et al. Telemedicine in COPD: An overview by topics. COPD 2020;17:601–17. DOI: https://doi.org/10.1080/15412555.2020.1815182
Longacre CF, Nyman JA, Visscher SL, et al. Cost-effectiveness of the Collaborative Care to Preserve Performance in Cancer (COPE) trial tele-rehabilitation interventions for patients with advanced cancers. Cancer Med 2020;9:2723–31. DOI: https://doi.org/10.1002/cam4.2837
Haesum LKE, Soerensen N, Dinesen B, et al. Cost-utility analysis of a telerehabilitation program: A case study of COPD patients. Telemed J E Health 2012;18:688–92. DOI: https://doi.org/10.1089/tmj.2011.0250
How to Cite
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.