Telerehabilitation for chronic respiratory disease: a randomised controlled equivalence trial
| Autor: | Aroub Lahham, Monique Corbett, Emma Handley, Bruna Wageck, Christie Mellerick, Amanda Nichols, Anne E Holland, Paolo Zanaboni, Ajay Mahal, Kathryn Barker, Pawel Czupryn, Christine F McDonald, Hayley Crute, Richard Wootton, Catherine J. Hill, Janet Bondarenko, Angela T Burge, Jennifer A. Alison, Paul O'Halloran, Narelle S Cox, Helen Boursinos, Heather MacDonald |
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| Rok vydání: | 2021 |
| Předmět: |
Pulmonary and Respiratory Medicine
medicine.medical_specialty Blinding business.industry medicine.medical_treatment Respiratory disease Respiration Disorders medicine.disease Rehabilitation Centers law.invention Pulmonary Disease Chronic Obstructive Dyspnea Equivalence Trial Randomized controlled trial Quality of life law Telerehabilitation Quality of Life Physical therapy medicine Humans Effective treatment Pulmonary rehabilitation business |
| Zdroj: | Thorax. 77:643-651 |
| ISSN: | 1468-3296 0040-6376 |
| DOI: | 10.1136/thoraxjnl-2021-216934 |
| Popis: | RationalePulmonary rehabilitation is an effective treatment for people with chronic respiratory disease but is delivered to MethodsA multicentre randomised controlled trial with assessor blinding, powered for equivalence was undertaken. Individuals with a chronic respiratory disease referred to pulmonary rehabilitation at four participating sites (one rural) were eligible and randomised using concealed allocation to pulmonary rehabilitation or telerehabilitation. Both programmes were two times per week for 8 weeks. The primary outcome was change in Chronic Respiratory Disease Questionnaire Dyspnoea (CRQ-D) domain at end-rehabilitation, with a prespecified equivalence margin of 2.5 points. Follow-up was at 12 months. Secondary outcomes included exercise capacity, health-related quality of life, symptoms, self-efficacy and psychological well-being.Results142 participants were randomised to pulmonary rehabilitation or telerehabilitation with 96% and 97% included in the intention-to-treat analysis, respectively. There were no significant differences between groups for any outcome at either time point. Both groups achieved meaningful improvement in dyspnoea and exercise capacity at end-rehabilitation. However, we were unable to confirm equivalence of telerehabilitation for the primary outcome ΔCRQ-D at end-rehabilitation (mean difference (MD) (95% CI) −1 point (−3 to 1)), and inferiority of telerehabilitation could not be excluded at either time point (12-month follow-up: MD −1 point (95% CI −4 to 1)). At end-rehabilitation, telerehabilitation demonstrated equivalence for 6-minute walk distance (MD −6 m, 95% CI −26 to 15) with possibly superiority of telerehabilitation at 12 months (MD 14 m, 95% CI −10 to 38).Conclusiontelerehabilitation may not be equivalent to centre-based pulmonary rehabilitation for all outcomes, but is safe and achieves clinically meaningful benefits. When centre-based pulmonary rehabilitation is not available, telerehabilitation may provide an alternative programme model.Trial registration numberACtelerehabilitationN12616000360415. |
| Databáze: | OpenAIRE |
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