Effectiveness of telephone monitored home exercise for patients with COPD

Abstract

<b>Introduction:</b> Pulmonary Rehabilitation (PR) is highly effective but has poor national uptake. Due to COVID-19, PR services shifted to remote interventions, opening up potential alternative options for patients post-pandemic. <b>Aim:</b> To evaluate the safety and effectiveness of home exercise with weekly telephone follow-up in patients with COPD. <b>Methods:</b> Patients referred for PR were remotely assessed between June and December 2020. Appropriate patients chose either online exercise classes or an individualised exercise programme to complete thrice weekly with weekly telephone support for seven weeks. Adverse events were recorded. 1-minute sit-to-stand (STS), COPD assessment test (CAT), and MRC were completed pre- and post-course. Changes in outcomes are reported as mean (±SD). Paired t-tests assessed within subject change. <b>Results:</b> 113 patients (90%) enrolled in the telephone intervention (age 66±11 years, 55% male, FEV1% predicted 59±23%), of which 58 (51%) participated in seven calls and were reassessed. Mean change was: STS 2.4±6.1 repetitions (p=0.002), CAT -4.2±5.8 (p&lt;0.001) and MRC -0.4±0.8 (p=0.001). No adverse events were reported. <b>Conclusion:</b> Telephone monitored unsupervised exercise appears safe and effective in patients with stable COPD with improvements in exercise capacity, health status and breathlessness. A clinically significant improvement was seen in CAT with statistically significant improvements in CAT, STS and MRC. The improvement in STS and MRC did not reach the MCID established for PR but this intervention was not PR per se and MRC is insensitive to change. This intervention may offer an alternative option for future patients and improve access to exercise based treatments.