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Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease: protocol for a randomised controlled trial


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Cox, NS, McDonald, CF, Alison, JA, Mahal, A, Wootton, R, Hill, CJ, Bondarenko, J, Macdonald, H, O'Halloran, P, Zanaboni, P, Clarke, K, Rennick, D, Borgelt, K, Burge, AT, Lahham, A ORCID: 0000-0003-2090-0746, Wageck, B, Crute, H, Czupryn, P, Nichols, A and Holland, AE 2018 , 'Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease: protocol for a randomised controlled trial' , BMC Pulmonary Medicine, vol. 18, no. 1 , pp. 1-9 , doi: 10.1186/s12890-018-0646-0.

PDF (Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease: Protocol for a randomised controlled trial. BMC Pulmonary Medicine. Accepted 05 May 2018.)
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Background: Pulmonary rehabilitation is an effective therapeutic intervention for people with chronic respiratory disease. However, fewer than 5% of eligible individuals receive pulmonary rehabilitation on an annual basis, largely due to limited availability of services and difficulties associated with travel and transport. The Rehabilitation Exercise At Home (REAcH) study is an assessor-blinded, multi-centre, randomised controlled equivalence trial designed to compare the efficacy of home-based telerehabilitation and traditional centre-based pulmonary rehabilitation in people with chronic respiratory disease.Methods: Participants will undertake an 8-week group-based pulmonary rehabilitation program of twice-weekly supervised exercise training, either in-person at a centre-based pulmonary rehabilitation program or remotely from their home via the Internet. Supervised exercise training sessions will include 30 min of aerobic exercise (cycle and/or walking training). Individualised education and self-management training will be delivered. All participants will be prescribed a home exercise program of walking and strengthening activities. Outcomes will be assessed by a blinded assessor at baseline, after completion of the intervention, and 12-months post intervention. The primary outcome is change in dyspnea score as measured by the Chronic Respiratory Questionnaire - dyspnea domain (CRQ-D). Secondary outcomes will evaluate the efficacy of telerehabilitation on 6-min walk distance, endurance cycle time during a constant work rate test, physical activity and quality of life. Adherence to pulmonary rehabilitation between the two models will be compared. A full economic analysis from a societal perspective will be undertaken to determine the cost-effectiveness of telerehabilitation compared to centre-based pulmonary rehabilitation.Discussion: Alternative models of pulmonary rehabilitation are required to improve both equity of access and patient-related outcomes. This trial will establish whether telerehabilitation can achieve equivalent improvement in outcomes compared to traditional centre-based pulmonary rehabilitation. If efficacious and cost-effective, the proposed telerehabilitation model is designed to be rapidly deployed into clinical practice.

Item Type: Article
Authors/Creators:Cox, NS and McDonald, CF and Alison, JA and Mahal, A and Wootton, R and Hill, CJ and Bondarenko, J and Macdonald, H and O'Halloran, P and Zanaboni, P and Clarke, K and Rennick, D and Borgelt, K and Burge, AT and Lahham, A and Wageck, B and Crute, H and Czupryn, P and Nichols, A and Holland, AE
Keywords: asthma, bronchiectasis, chronic obstructive pulmonary disease, exercise, interstitial lung disease, pulmonary rehabilitation, respiratory disease, telehealth, telerehabilitation
Journal or Publication Title: BMC Pulmonary Medicine
Publisher: BioMed Central Ltd.
ISSN: 1471-2466
DOI / ID Number: 10.1186/s12890-018-0646-0
Copyright Information:

© 2018 The Authors. Licensed under Creative Commons Attribution 4.0 International (CC BY 4.0)

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