Is Virtual Pulmonary Rehabilitation (PR) a feasible and effective alternative to Face to Face?

ABSTRACT

Introduction: Face to Face (FTF) PR is a gold standard treatment for chronic respiratory diseases. However low uptake is reported (Sing, S. et al. NACAP 2020). Evaluating virtual alternatives is important when considering methods to improve uptake. Aim(s) To determine the feasibility, and efficacy of virtual PR (VPR). Method(s) Covid-19 led to VPR replacing FTF in 3 London boroughs from March 2020-May 2021. VPR included videoconferencing supported group aerobic and resistance training. The 1 minute sit to stand (1MSTS), CRQ, CAT, HAD and Lung Information Needs Questionnaire (LINQ) were completed pre and post VPR. Result(s) 695 patients were referred with 181 (26%) enrolled into VPR (mean age 67.5+/-11.8;%predicted FEV1 62+/-23.1). 138 completed (76% of enrolled). Reasons for non-enrolment were digital access (n=125), clinical reasons (n=138), declined/non-contactable (n=251). There were significant improvements in 1MSTS (3.3+/-5.3;p<0.001);CRQ-dyspnoea (0.56+/-1.1;p<0.001);emotional functioning (0.32+/-0.9;p<0.001);mastery (0.53+/-1.1;P<0.001);fatigue (0.39+/-1.0;p<0.0001), total (0.43+/-0.8;p<0.001);CAT (-2.2+/-5.4;P<0.001);LINQ (-2.8+/-2.6 P<0.001) and HAD-D (-1.2+/-2.8;P<0.001). 1MSTS, CAT, LINQ, CRQ dyspnoea and mastery exceeded the minimal clinically important differences (MCID). 86% of patients met the MCID for health status and 54% for exercise tolerance (ET). Conclusion(s) VPR was feasible and efficacious in some patients. Our data shows higher completion rates in those enrolled than national F2F data with more patients meeting the health status MCID but less for exercise tolerance. Further work is needed to improve digital access for VPR.