Virtual Physical Therapy Practices in Canadian Exercise-Based Pulmonary Rehabilitation Programs

Abstract

Purpose: To understand the current physical therapy virtual care practices in Canadian pulmonary rehabilitation programs. Methods: Exercise-based pulmonary rehabilitation programs were identified through Canadian pulmonary associations available on public websites. Physiotherapists at eligible sites were emailed a web-based survey (REDCap) between March and June 2023. Results: 31/61 survey recipients from 56 programs completed the survey (response rate = 51%). A majority of participants ( n = 20, 65%) reported using a hybrid (mix of virtual and in-person) delivery model in the preceding 6 months. Assessments of exercise capacity, respiratory status, exertional oxygen requirements, and physical function were primarily conducted in-person, whereas exercise prescription and progression, respiratory treatment, psychosocial support, vital sign monitoring, and education were conducted both in-person and virtually. Commonly reported enablers to virtual care were patient preference, medical stability, and availability of technological equipment. Clinical practice guidelines alongside continuing education and training opportunities were identified as important resources needed to optimize virtual or hybrid rehabilitation delivery. Conclusions: Following the COVID-19 pandemic there has been a shift towards a hybrid model of exercise-based pulmonary rehabilitation delivered by physiotherapists. Expanding the evidence base particularly around the clinical utility of virtual assessment may further inform virtual care practices.