P3.16-024 Feasibility of the Fit4Surgery App - Can It Replace Conventional Pulmonary Rehabilitation in the Surgical Population?

Abstract

Perioperative exercise and physiotherapy is increasingly recognized as beneficial for preparation and recovery in patients undergoing lung cancer surgery. Time and resource constraints may be a barrier to referral for rehabilitation prior to lung cancer surgery. We aimed to establish if provision of an exercise app to use at home would enable patients to exercise more frequently than attendance at classes and determine what the patient experience of using the app was. We developed an app for an Apple iPad which utilized a Bluetooth connection to a pulse oximeter to provide patients with real time feedback on their pulse rate and oxygen saturations during exercise. The app guides patients in doing pulmonary rehabilitation exercises, which can be made more intense or gentler depending on baseline fitness. We conducted a prospective cohort study to test use of the app by patients at home before and after lung cancer resection. Incremental shuttle walk tests were performed before and after using the app to investigate the difference in preoperative functional capacity. Patients were asked to complete semi structured telephone interviews to comment on their experience of the app. Transcripts of interviews were analyzed using content analysis to categorize and highlight the important messages from patients. During the 14 month study 37 patients were recruited. A variety of patients participated; the age range was 33 to 84 years and FEV1 range was 45% to 124% predicted. The average number of sessions completed on the app was 4, double the amount if they were attending pulmonary rehabilitation classes prior to lung cancer surgery. All patients except one improved their incremental shuttle walk distance before surgery. Interviews yielded five key messages about the app; patients had a range of motivations for taking part in the study, it was simple to use, patients had a positive experience using it, they had tips for improving it and they thought it had had an impact upon their fitness levels. All the patients found the app convenient to help them perform exercises outside of hospital. Patients welcomed the app and immediate provision of the app eliminated any delay in accessing support to exercise. Patients were able to perform more sessions of exercise by using it at home as opposed to hospital based exercises classes. It was feasible to use the app in all types of patients attending for surgery and a multi-center study is indicated to assess the impact upon postoperative outcomes.