10
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: a randomised multicentre trial

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Rationale

          Pulmonary rehabilitation (PR) is an effective, key standard treatment for people with COPD. Nevertheless, low participant uptake, insufficient attendance and high drop-out rates are reported. Investigation is warranted of the benefits achieved through alternative approaches, such as pulmonary tele-rehabilitation (PTR).

          Objective

          To investigate whether PTR is superior to conventional PR on 6 min walk distance (6MWD) and secondarily on respiratory symptoms, quality of life, physical activity and lower limb muscle function in patients with COPD and FEV 1 <50% eligible for routine hospital-based, outpatient PR.

          Methods

          In this single-blinded, multicentre, superiority randomised controlled trial, patients were assigned 1:1 to 10 weeks of groups-based PTR (60 min, three times weekly) or conventional PR (90 min, two times weekly). Assessments were performed by blinded assessors at baseline, end of intervention and at 22 weeks’ follow-up from baseline. The primary analysis was based on the intention-to-treat principle.

          Measurements and main results

          The primary outcome was change in 6MWD from baseline to 10 weeks; 134 participants (74 females, mean±SD age 68±9 years, FEV 1 33%±9% predicted, 6MWD 327±103 metres) were included and randomised. The analysis showed no between-group differences for changes in 6MWD after intervention (9.2 metres (95% CI: −6.6 to 24.9)) or at 22 weeks’ follow-up (−5.3 metres (95% CI: −28.9 to 18.3)). More participants completed the PTR intervention (n=57) than conventional PR (n=43) (χ 2 test p<0.01).

          Conclusion

          PTR was not superior to conventional PR on the 6MWD and we found no differences between groups. As more participants completed PTR, supervised PTR would be relevant to compare with conventional PR in a non-inferiority design.

          Trial registration number

          ClinicalTrials.gov (NCT02667171), 28 January 2016.

          Related collections

          Most cited references29

          • Record: found
          • Abstract: found
          • Article: not found

          An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation.

          Pulmonary rehabilitation is recognized as a core component of the management of individuals with chronic respiratory disease. Since the 2006 American Thoracic Society (ATS)/European Respiratory Society (ERS) Statement on Pulmonary Rehabilitation, there has been considerable growth in our knowledge of its efficacy and scope. The purpose of this Statement is to update the 2006 document, including a new definition of pulmonary rehabilitation and highlighting key concepts and major advances in the field. A multidisciplinary committee of experts representing the ATS Pulmonary Rehabilitation Assembly and the ERS Scientific Group 01.02, "Rehabilitation and Chronic Care," determined the overall scope of this update through group consensus. Focused literature reviews in key topic areas were conducted by committee members with relevant clinical and scientific expertise. The final content of this Statement was agreed on by all members. An updated definition of pulmonary rehabilitation is proposed. New data are presented on the science and application of pulmonary rehabilitation, including its effectiveness in acutely ill individuals with chronic obstructive pulmonary disease, and in individuals with other chronic respiratory diseases. The important role of pulmonary rehabilitation in chronic disease management is highlighted. In addition, the role of health behavior change in optimizing and maintaining benefits is discussed. The considerable growth in the science and application of pulmonary rehabilitation since 2006 adds further support for its efficacy in a wide range of individuals with chronic respiratory disease.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Pulmonary rehabilitation for chronic obstructive pulmonary disease.

            Widespread application of pulmonary rehabilitation (also known as respiratory rehabilitation) in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function (health-related quality of life, functional and maximal exercise capacity) attributable to the programmes. This review updates the review reported in 2006.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease.

              Field walking tests are commonly employed to evaluate exercise capacity, assess prognosis and evaluate treatment response in chronic respiratory diseases. In recent years, there has been a wealth of new literature pertinent to the conduct of the 6-min walk test (6MWT), and a growing evidence base describing the incremental and endurance shuttle walk tests (ISWT and ESWT, respectively). The aim of this document is to describe the standard operating procedures for the 6MWT, ISWT and ESWT, which can be consistently employed by clinicians and researchers. The Technical Standard was developed by a multidisciplinary and international group of clinicians and researchers with expertise in the application of field walking tests. The procedures are underpinned by a concurrent systematic review of literature relevant to measurement properties and test conduct in adults with chronic respiratory disease. Current data confirm that the 6MWT, ISWT and ESWT are valid, reliable and responsive to change with some interventions. However, results are sensitive to small changes in methodology. It is important that two tests are conducted for the 6MWT and ISWT. This Technical Standard for field walking tests reflects current evidence regarding procedures that should be used to achieve robust results.
                Bookmark

                Author and article information

                Journal
                Thorax
                Thorax
                thoraxjnl
                thorax
                Thorax
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0040-6376
                1468-3296
                May 2020
                30 March 2020
                : 75
                : 5
                : 413-421
                Affiliations
                [1 ] departmentRespiratory Research Unit, Department of Respiratory Medicine , Hvidovre Hospital , Hvidovre, Denmark
                [2 ] departmentDepartment of Physical and Occupational Therapy , Bispebjerg Hospital , Copenhagen, Denmark
                [3 ] departmentInstitute for Clinical Medicine , University of Copenhagen Faculty of Health and Medical Sciences , Copenhagen, Denmark
                [4 ] departmentClinical Research Center , Copenhagen University Hospital Amager and Hvidovre , Hvidovre, Denmark
                [5 ] departmentDepartment of Pulmonary Medicine , Gentofte Hospital , Hellerup, Denmark
                [6 ] departmentDepartment of Respiratory Medicine , Bispebjerg Hospital , Copenhagen, Denmark
                [7 ] departmentDepartment of Respiratory Medicine , Hvidovre Hospital , Hvidovre, Denmark
                [8 ] departmentDepartment of Respiratory Medicine and Infectious Diseases , Hillerød Hospital , Hillerød, Denmark
                [9 ] departmentDepartment of Public Health , University of Copenhagen Faculty of Health Sciences , Copenhagen, Denmark
                Author notes
                [Correspondence to ] Dr Henrik Hansen, Respiratory Research Unit, Department of Respiratory Medicine, Hvidovre Hospital, Hvidovre, Denmark; henrik.hansen.09@ 123456regionh.dk
                Article
                thoraxjnl-2019-214246
                10.1136/thoraxjnl-2019-214246
                7231436
                32229541
                68cbc886-5338-45db-a8ea-1b9a9ef24f73
                © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 24 October 2019
                : 14 February 2020
                : 03 March 2020
                Funding
                Funded by: Danish Lung Foundation (Charitable funding);
                Award ID: F-12910-01-17-01
                Funded by: TrygFonden foundation (Charitable funding);
                Award ID: 111704
                Funded by: Telemedical Center Regional Capital Copenhagen (governmental funding);
                Award ID: L-42057-00025
                Categories
                Rehabilitation
                1506
                2313
                Original research
                Custom metadata
                unlocked

                Surgery
                pulmonary rehabilitation,exercise
                Surgery
                pulmonary rehabilitation, exercise

                Comments

                Comment on this article