title: In-Home Pulmonary Telerehabilitation for Patients with Chronic Obstructive Pulmonary Disease: A Pre-experimental Study on Effectiveness, Satisfaction, and Adherence.
abstract: BACKGROUND
  Pulmonary rehabilitation (PR) has proven effective in improving exercise tolerance and quality of life in patients with chronic obstructive pulmonary disease (COPD). In Canada, however, there are insufficient rehabilitation services. New strategies such as telerehabilitation must be deployed to increase accessibility. This study aims to investigate the effect of telerehabilitation on exercise tolerance and quality of life and to document patient satisfaction and adherence.
  
  
  METHODS
  Twenty-six patients with moderate to very severe COPD participated in this pre-/postintervention study. They received 15 in-home teletreatment sessions over 8 weeks via videoconference from a service center to their home. Education was provided via self-learning health capsules. Assessments were carried out twice before (T0 and T1; 8 weeks apart) and immediately after the intervention (T2). Primary outcome measures were changes in exercise tolerance (6-min walk test [6MWT] and cycle endurance test [CET]) and quality of life (Chronic Respiratory Questionnaire [CRQ]).
  
  
  RESULTS
  There were significant improvements between pre- and postintervention (T2-T1) on the 6MWT (32 m; p<0.001), CET (41 s; p=0.005), and three of four CRQ domains (dyspnea [p<0.001], fatigue [p=0.002], and emotion [p=0.002]). Improvements in the CET and fatigue during the 8-week intervention period were greater than changes over 8 weeks of maturation (T1-T0) (p=0.004 and 0.02, respectively). Participants' satisfaction and adherence rate with telerehabilitation were very high.
  
  
  CONCLUSIONS
  Using telehealth technology to deliver in-home PR is a feasible and practical solution for patients with moderate to very severe COPD. The telerehabilitation program was associated with beneficial effects on exercise tolerance and quality of life and was well received by users.
authors.affiliation: 1 Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, University of Sherbrooke , Sherbrooke, Quebec, Canada .
authors.forename: Nicole
authors.initials: N
authors.lastname: Marquis
authors.affiliation: 2 Respiratory Division, Department of Medicine, Faculty of Medicine and Health Sciences, University of Sherbrooke , Sherbrooke, Quebec, Canada .
authors.forename: Pierre
authors.initials: P
authors.lastname: Larivée
authors.affiliation: 3 Centre de Recherche, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval , Quebec, Quebec, Canada .
authors.forename: Didier
authors.initials: D
authors.lastname: Saey
authors.affiliation: 1 Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, University of Sherbrooke , Sherbrooke, Quebec, Canada .
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Dubois
authors.affiliation: 1 Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, University of Sherbrooke , Sherbrooke, Quebec, Canada .
authors.forename: Michel
authors.initials: M
authors.lastname: Tousignant
mesh_terms: D000368:Aged; D002170:Canada; D004644:Emotions; D017079:Exercise Tolerance; D005221:Fatigue; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000458:organization & administration; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D000069350:Telerehabilitation / Q000458:organization & administration*
keywords: chronic obstructive pulmonary disease; exercise tolerance; pulmonary rehabilitation; quality of life; telehealth technology; videoconference