title: Pulmonary rehabilitation at home guided by telemonitoring and access to healthcare facilities for respiratory complications in patients with neuromuscular disease.
abstract: BACKGROUND
  Pulmonary complications are the main cause of morbidity and mortality in neuromuscular patients. Aim of this study was to evaluate the feasibility of a home follow-up program combining telemonitoring and chest physiotherapy (CPT) in preventing acute respiratory episodes.
  
  
  METHODS
  Prospective observational study in a period of 24 months, and comparison with preintervention data of the same patients.
  
  
  METHODS
  Outpatients and community.
  
  
  METHODS
  Neuromuscular patients. Enrolment criteria were: reduced efficacy of cough, high family support, long home-to-hospital distance.
  
  
  METHODS
  Caregivers and patients had to register daily respiratory signs and symptoms. Each patient was equipped with a pulse oximeter with a modem for transmitting data to a remote control center, in charge of alerting the pulmonologist in case of sign and symptom deterioration. CPT interventions at home were planned after indication by the pulmonologist. The number of emergency room admissions or hospitalization following respiratory exacerbations were registered.
  
  
  RESULTS
  Thirteen patients were enrolled. In the first year of monitoring, 18 alerts were transmitted to the pulmonologist, average 1.38±1.38 alert/patient. In the second year, the number of alerts were 5, average 0.38±0.65 alert/patient (P<0.01). In 24 months, 241 respiratory therapists' interventions were conducted on 11 patients. In the first 12 months there were four episodes of hospitalisation, none in the following 12 months. In the year prior to the project, there were seven cases of hospitalisation and one case of emergency room admission.
  
  
  CONCLUSIONS
  The combination of telemonitoring and CPT at home is feasible in the long-term for patients with neuromuscular disease.
  
  
  CONCLUSIONS
  An apparent reduction of hospitalisation and emergency room admissions for respiratory complications can justify a randomized control trial to confirm efficacy and effectiveness.
authors: Respiratory Rehabilitation Unit, AUSL Reggio Emilia, Ospedale S. Sebastiano, Correggio, Reggio Emilia, Italy. garutigi@ausl.re.it
authors: G
authors: G
authors: Garuti
authors: S
authors: S
authors: Bagatti
authors: E
authors: E
authors: Verucchi
authors: M
authors: M
authors: Massobrio
authors: L
authors: L
authors: Spagnolatti
authors: G
authors: G
authors: Vezzani
authors: M
authors: M
authors: Lusuardi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D018575:Home Care Services, Hospital-Based; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods; D009468:Neuromuscular Diseases / Q000150:complications / Q000175:diagnosis / Q000534:rehabilitation*; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D011446:Prospective Studies; D012120:Respiration Disorders / Q000209:etiology / Q000534:rehabilitation*; D012121:Respiration, Artificial / Q000379:methods; D012138:Respiratory Therapy / Q000379:methods*; D018570:Risk Assessment; D013686:Telemetry / Q000379:methods*; D014139:Tracheostomy / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult