Efficacy Of Telerehabilitation On Exercise Capacity And Frailty In Veterans With Chronic Pulmonary Obstructive Disease

Abstract

Chronic obstructive pulmonary disease (COPD) affects nearly 5 percent of US Veterans. Reduced exercise capacity and increased vulnerability are key features associated with COPD. Center-based exercise programs are effective treatments, however efficacy of the delivery of exercise programs through telemedicine is largely unknown. PURPOSE: To investigate the efficacy of 12-week pulmonary telerehabilitation on exercise capacity and vulnerability in Veterans with COPD. METHODS: Veterans with COPD (n = 41 [39 men]; age = 68.1 ± 8.7 years; body-mass index = 30.06 ± 5.34 kg/m2; forced volume in one second [FEV1] = 46 ± 15%; forced volume in one second/forced vital capacity [FEV1/FVC] = 53 ± 14%; oxygen saturation [SPO2] = 93 ± 3%) participated after signing a written informed consent. Participants received exercise treatment consisted of strengthening and balance exercises, respiratory exercise and related educations (i.e., smoking cessation, nutrition, sleep hygiene) provided by a physical therapist and a respiratory therapist through Veterans Affairs telehealth service. Outcome measures were 6-minute walk distance (exercise capacity measure) and Fried frailty phenotype (vulnerability measure). RESULTS: Results for the outcome measures are shown in Table 1. Across all participants, 6-minute walk distance increased by 15.7% after the telerehabilitation program (p < 0.001; medium effect size). For frailty status, compared to baseline, eight more Veterans (19.5% of all participants) were classified as non-frail after the telerehabilitation program, however, these improvements did not reach a statistically significant level (p = 0.069). CONCLUSIONS: The 12-week cardiopulmonary telerehabilitation is effective in improving exercise capacity and may also be effective in treating vulnerability in Veterans with COPD.