Virtual pulmonary rehabilitation: A worthwhile intervention?

ABSTRACT

Introduction: and Objectives: The Covid 19 pandemic has had a monumental effect on healthcare services. Within the NHS, the majority of services are delivered face to face, and during the height of the pandemic, this became impossible. There is an undeniable body of evidence that traditional PR classes offer those living with chronic lung disease an opportunity to learn and understand how best to manage their condition. There are well established Virtual PR platforms in the UK but most have expensive licence fees. Recognising many months without intervention would have a detrimental effect to the health of service users, it became essential to offer virtual pulmonary rehabilitation (VPR). Outcomes from VPR have been gathered and analysed against those from traditional PR to see if the new intervention was safe, effective and worthwhile, whilst providing meaningful changes to exercise capacity and psychological wellbeing. Methods: Participants completed a seven week course run by Qualified Physiotherapists and Occupational Therapists. They were given a programme of aerobic and strength exercises were advised to complete twice weekly exercise sessions building up intensity and frequency as the weeks progressed. During the intervention patients were contacted up to twice weekly via telephone or video call. Education was provided informally in booklet format. Patients were assessed pre-and post-intervention using the 1 minute sit-to stand test, Chronic Respiratory questionnaire - self reported (CRQ-SR), GAD-7 and PHQ-9, and MRC. Results: 40 participants have completed VPR in the first wave. 61% of participants achieved the MCID for the 1 minute STS test. 52% achieved the MCID in all domains of CRQ-SR. Average MRC scores improved from 3.2 to 2.7;an average improvement of 0.5. Conclusions: The Covid pandemic offered an opportunity to explore the potential of VPR. There is evidence of good individual successes, however upon reflection, outcomes were collectively less favourable than traditional PR. Longterm, VPR offers a welcome alternative method of accessing PR services for those unable to access traditional PR. However, further research should be completed into identifying characteristics of those who will be most likely to succeed at VPR.