Long-Term Telerehabilitation or Unsupervised Training at Home for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Autor: Paolo Zanaboni, Birthe Dinesen, Hanne Hoaas, Richard Wootton, Angela T. Burge, Rochelle Philp, Cristino Carneiro Oliveira, Janet Bondarenko, Torben Tranborg Jensen, Belinda R. Miller, Anne E. Holland
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Zanaboni, P, Dinesen, B, Hoaas, H, Wootton, R, Burge, A T, Philp, R, Oliveira, C C, Bondarenko, J, Tranborg Jensen, T, Miller, B R & Holland, A E 2022, ' Long-Term Telerehabilitation or Unsupervised Training at Home for Patients with Chronic Obstructive Pulmonary Disease : A Randomized Controlled Trial ', American Journal of Respiratory and Critical Care Medicine . https://doi.org/10.1164/rccm.202204-0643OC
DOI: 10.1164/rccm.202204-0643OC
Popis: RATIONALE: Despite the benefits of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD), many patients do not access or complete pulmonary rehabilitation, and long-term maintenance of exercise is difficult.OBJECTIVES: To compare long-term telerehabilitation or unsupervised treadmill training at home with standard care.METHODS: In an international randomized controlled trial, patients with COPD were assigned to three groups (telerehabilitation, unsupervised training, control) and followed up for 2 years. Telerehabilitation consisted of individualized treadmill training at home supervised by a physiotherapist and self-management. The unsupervised training group performed unsupervised treadmill exercise at home. The control group received standard care. The primary outcome was the combined number of hospitalizations and emergency department presentations. Secondary outcomes included time free from first event; exercise capacity; dyspnea; health status; quality of life; anxiety; depression; self-efficacy; subjective impression of change.MEASUREMENTS AND MAIN RESULTS: 120 participants were randomized. The incidence rate of hospitalizations and emergency department presentations was lower in telerehabilitation (1.18 events per person-year, 95% CI: 0.94, 1.46) and unsupervised training group (1.14, 95% CI: 0.92, 1.41) than in the control group (1.88, 95% CI: 1.58, 2.21; P < 0.001 compared to intervention groups). Telerehabilitation and unsupervised training groups experienced better health status for 1 year. Intervention participants reached and maintained clinically significant improvements in exercise capacity.CONCLUSIONS: Long-term telerehabilitation and unsupervised training at home in COPD are both successful in reducing hospital readmissions and can broaden the availability of pulmonary rehabilitation and maintenance strategies. Clinical trial registration available at www.CLINICALTRIALS: gov, ID: NCT02258646. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Databáze: OpenAIRE