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      Delivering an in-Home Exercise Program via Telerehabilitation: A Pilot Study of Lung Transplant Go (LTGO)

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          Abstract

          We evaluated the feasibility, safety, system usability, and intervention acceptability of Lung Transplant Go (LTGO), an 8-week in-home exercise intervention for lung transplant recipients using a telerehabilitation platform, and described changes in physical function and physical activity from baseline to post-intervention. The intervention was delivered to lung transplant recipients in their home via the Versatile and Integrated System for TeleRehabilitation (VISYTER). The intervention focused on aerobic and strengthening exercises tailored to baseline physical function. Participants improved walk distance (6-minute walk distance), balance (Berg Balance Scale), lower body strength (30-second chair stand test) and steps walked ( SenseWear Armband®). No adverse events were reported. Participants rated the program highly positively in regard to the technology and intervention. The telerehabilitation exercise program was feasible, safe, and acceptable. Our findings provide preliminary support for the LTGO intervention to improve physical function and promote physical activity in lung transplant recipients.

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          Most cited references30

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          An Official American Thoracic Society/European Respiratory Society Policy Statement: Enhancing Implementation, Use, and Delivery of Pulmonary Rehabilitation.

          Pulmonary rehabilitation (PR) has demonstrated physiological, symptom-reducing, psychosocial, and health economic benefits for patients with chronic respiratory diseases, yet it is underutilized worldwide. Insufficient funding, resources, and reimbursement; lack of healthcare professional, payer, and patient awareness and knowledge; and additional patient-related barriers all contribute to the gap between the knowledge of the science and benefits of PR and the actual delivery of PR services to suitable patients.
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            The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke.

            The objective of this study was to assess the reliability of the Balance Scale. Subjects were chosen from a larger group of 113 elderly residents and 70 stroke patients participating in a psychometric study. Elderly residents were examined at baseline, and at 3, 6 and 9 months, and the stroke patients were evaluated at 2, 4, 6 and 12 weeks post onset. The Cronbach's alphas at each evaluation were greater than 0.83 and 0.97 for the elderly residents and stroke patients respectively, showing strong internal consistency. To assess inter-rater reliability, therapists treating 35 stroke patients were asked to administer the Balance Scale within 24 hours of the independent evaluator. Similarly, caregivers at the Residence were asked to test the elderly residents within one week of the independent evaluator. To assess intra-rater reliability, 18 residents and 6 stroke patients were assessed one week apart by the same rater. The agreement between raters was excellent (ICC = 0.98) as was the consistency within the same rater at two points in time (ICC = 0.97). The results support the use of the Balance Scale in these groups.
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              Interpreting small differences in functional status: the Six Minute Walk test in chronic lung disease patients.

              Functional status measurements are often difficult to interpret because small differences may be statistically significant but not clinically significant. How much does the Six Minute Walk test (6MW) need to differ to signify a noticeable difference in walking ability for patients with chronic obstructive pulmonary disease (COPD)? We studied individuals with stable COPD (n = 112, mean age = 67 yr, mean FEV1 = 975 ml) and estimated the smallest difference in 6MW distances that was associated with a noticeable difference in patients' subjective comparison ratings of their walking ability. We found that the 6MW was significantly correlated with patients' ratings of their walking ability relative to other patients (r = 0.59, 95% confidence interval [CI]: 0.54 to 0.63). Distances needed to differ by 54 m for the average patient to stop rating themselves as "about the same" and start rating themselves as either "a little bit better" or "a little bit worse" (95% CI: 37 to 71 m). We suggest that differences in functional status can be statistically significant but below the threshold at which patients notice a difference in themselves relative to others; an awareness of the smallest difference in walking distance that is noticeable to patients may help clinicians interpret the effectiveness of symptomatic treatments for COPD.
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                Author and article information

                Journal
                Int J Telerehabil
                Int J Telerehabil
                IJT
                International Journal of Telerehabilitation
                University Library System, University of Pittsburgh
                1945-2020
                Fall 2016
                15 December 2016
                : 8
                : 2
                : 15-26
                Affiliations
                [1 ]DEPARTMENT OF ACUTE & TERTIARY CARE, SCHOOL OF NURSING, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
                [2 ]DEPARTMENT OF PHYSICAL THERAPY, SCHOOL OF HEALTH AND REHABILITATION SCIENCE, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
                [3 ]DEPARTMENT OF HEALTH & COMMUNITY SYSTEMS, SCHOOL OF NURSING, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
                [4 ]DIVISION OF PULMONARY ALLERGY AND CRITICAL CARE MEDICINE, DEPARTMENT OF MEDICINE, UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE & SCHOOL OF NURSING, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
                [5 ]DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION SCIENCE, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PENNSYLVANIA, USA
                Article
                ijt-08-15
                10.5195/ijt.2016.6201
                5536726
                6951c630-77cd-4b40-908a-8626218ed541
                Copyright @ 2016

                This work is licensed under a Creative Commons Attribution 4.0 International License

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                home exercise program,lung transplantation,pulmonary rehabilitation,telerehabilitation

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