Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease: Protocol for a randomised controlled trial

Narelle S. Cox, Christine F. McDonald, Jennifer A. Alison, Ajay Mahal, Richard Wootton, Catherine J. Hill, Janet Bondarenko, Heather Macdonald, Paul D. O'Halloran, Paolo Zanaboni, Ken Clarke, Deidre Rennick, Kaye Borgelt, Angela T. Burge, Aroub Lahham, Bruna Wageck, Hayley Crute, Pawel Czupryn, Amanda Nichols, Anne E. Holland

Research output: Contribution to journalArticleOtherpeer-review

3 Citations (Scopus)

Abstract

Background: Pulmonary rehabilitation is an effective therapeutic intervention for people with chronic respiratory disease. However, fewer than 5% of eligible individuals receive pulmonary rehabilitation on an annual basis, largely due to limited availability of services and difficulties associated with travel and transport. The Rehabilitation Exercise At Home (REAcH) study is an assessor-blinded, multi-centre, randomised controlled equivalence trial designed to compare the efficacy of home-based telerehabilitation and traditional centre-based pulmonary rehabilitation in people with chronic respiratory disease. Methods: Participants will undertake an 8-week group-based pulmonary rehabilitation program of twice-weekly supervised exercise training, either in-person at a centre-based pulmonary rehabilitation program or remotely from their home via the Internet. Supervised exercise training sessions will include 30 min of aerobic exercise (cycle and/or walking training). Individualised education and self-management training will be delivered. All participants will be prescribed a home exercise program of walking and strengthening activities. Outcomes will be assessed by a blinded assessor at baseline, after completion of the intervention, and 12-months post intervention. The primary outcome is change in dyspnea score as measured by the Chronic Respiratory Questionnaire - dyspnea domain (CRQ-D). Secondary outcomes will evaluate the efficacy of telerehabilitation on 6-min walk distance, endurance cycle time during a constant work rate test, physical activity and quality of life. Adherence to pulmonary rehabilitation between the two models will be compared. A full economic analysis from a societal perspective will be undertaken to determine the cost-effectiveness of telerehabilitation compared to centre-based pulmonary rehabilitation. Discussion: Alternative models of pulmonary rehabilitation are required to improve both equity of access and patient-related outcomes. This trial will establish whether telerehabilitation can achieve equivalent improvement in outcomes compared to traditional centre-based pulmonary rehabilitation. If efficacious and cost-effective, the proposed telerehabilitation model is designed to be rapidly deployed into clinical practice.

Original languageEnglish
Article number71
Number of pages9
JournalBMC Pulmonary Medicine
Volume18
Issue number1
DOIs
Publication statusPublished - 15 May 2018
Externally publishedYes

Keywords

  • Asthma
  • Bronchiectasis
  • Chronic obstructive pulmonary disease
  • Exercise
  • Interstitial lung disease
  • Pulmonary rehabilitation
  • Respiratory disease
  • Telehealth
  • Telerehabilitation

Cite this

Cox, Narelle S. ; McDonald, Christine F. ; Alison, Jennifer A. ; Mahal, Ajay ; Wootton, Richard ; Hill, Catherine J. ; Bondarenko, Janet ; Macdonald, Heather ; O'Halloran, Paul D. ; Zanaboni, Paolo ; Clarke, Ken ; Rennick, Deidre ; Borgelt, Kaye ; Burge, Angela T. ; Lahham, Aroub ; Wageck, Bruna ; Crute, Hayley ; Czupryn, Pawel ; Nichols, Amanda ; Holland, Anne E. / Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease : Protocol for a randomised controlled trial. In: BMC Pulmonary Medicine. 2018 ; Vol. 18, No. 1.
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abstract = "Background: Pulmonary rehabilitation is an effective therapeutic intervention for people with chronic respiratory disease. However, fewer than 5{\%} of eligible individuals receive pulmonary rehabilitation on an annual basis, largely due to limited availability of services and difficulties associated with travel and transport. The Rehabilitation Exercise At Home (REAcH) study is an assessor-blinded, multi-centre, randomised controlled equivalence trial designed to compare the efficacy of home-based telerehabilitation and traditional centre-based pulmonary rehabilitation in people with chronic respiratory disease. Methods: Participants will undertake an 8-week group-based pulmonary rehabilitation program of twice-weekly supervised exercise training, either in-person at a centre-based pulmonary rehabilitation program or remotely from their home via the Internet. Supervised exercise training sessions will include 30 min of aerobic exercise (cycle and/or walking training). Individualised education and self-management training will be delivered. All participants will be prescribed a home exercise program of walking and strengthening activities. Outcomes will be assessed by a blinded assessor at baseline, after completion of the intervention, and 12-months post intervention. The primary outcome is change in dyspnea score as measured by the Chronic Respiratory Questionnaire - dyspnea domain (CRQ-D). Secondary outcomes will evaluate the efficacy of telerehabilitation on 6-min walk distance, endurance cycle time during a constant work rate test, physical activity and quality of life. Adherence to pulmonary rehabilitation between the two models will be compared. A full economic analysis from a societal perspective will be undertaken to determine the cost-effectiveness of telerehabilitation compared to centre-based pulmonary rehabilitation. Discussion: Alternative models of pulmonary rehabilitation are required to improve both equity of access and patient-related outcomes. This trial will establish whether telerehabilitation can achieve equivalent improvement in outcomes compared to traditional centre-based pulmonary rehabilitation. If efficacious and cost-effective, the proposed telerehabilitation model is designed to be rapidly deployed into clinical practice.",
keywords = "Asthma, Bronchiectasis, Chronic obstructive pulmonary disease, Exercise, Interstitial lung disease, Pulmonary rehabilitation, Respiratory disease, Telehealth, Telerehabilitation",
author = "Cox, {Narelle S.} and McDonald, {Christine F.} and Alison, {Jennifer A.} and Ajay Mahal and Richard Wootton and Hill, {Catherine J.} and Janet Bondarenko and Heather Macdonald and O'Halloran, {Paul D.} and Paolo Zanaboni and Ken Clarke and Deidre Rennick and Kaye Borgelt and Burge, {Angela T.} and Aroub Lahham and Bruna Wageck and Hayley Crute and Pawel Czupryn and Amanda Nichols and Holland, {Anne E.}",
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Cox, NS, McDonald, CF, Alison, JA, Mahal, A, Wootton, R, Hill, CJ, Bondarenko, J, Macdonald, H, O'Halloran, PD, Zanaboni, P, Clarke, K, Rennick, D, Borgelt, K, Burge, AT, Lahham, A, Wageck, B, Crute, H, Czupryn, P, Nichols, A & Holland, AE 2018, 'Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease: Protocol for a randomised controlled trial', BMC Pulmonary Medicine, vol. 18, no. 1, 71. https://doi.org/10.1186/s12890-018-0646-0

Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease : Protocol for a randomised controlled trial. / Cox, Narelle S.; McDonald, Christine F.; Alison, Jennifer A.; Mahal, Ajay; Wootton, Richard; Hill, Catherine J.; Bondarenko, Janet; Macdonald, Heather; O'Halloran, Paul D.; Zanaboni, Paolo; Clarke, Ken; Rennick, Deidre; Borgelt, Kaye; Burge, Angela T.; Lahham, Aroub; Wageck, Bruna; Crute, Hayley; Czupryn, Pawel; Nichols, Amanda; Holland, Anne E.

In: BMC Pulmonary Medicine, Vol. 18, No. 1, 71, 15.05.2018.

Research output: Contribution to journalArticleOtherpeer-review

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T1 - Telerehabilitation versus traditional centre-based pulmonary rehabilitation for people with chronic respiratory disease

T2 - Protocol for a randomised controlled trial

AU - Cox, Narelle S.

AU - McDonald, Christine F.

AU - Alison, Jennifer A.

AU - Mahal, Ajay

AU - Wootton, Richard

AU - Hill, Catherine J.

AU - Bondarenko, Janet

AU - Macdonald, Heather

AU - O'Halloran, Paul D.

AU - Zanaboni, Paolo

AU - Clarke, Ken

AU - Rennick, Deidre

AU - Borgelt, Kaye

AU - Burge, Angela T.

AU - Lahham, Aroub

AU - Wageck, Bruna

AU - Crute, Hayley

AU - Czupryn, Pawel

AU - Nichols, Amanda

AU - Holland, Anne E.

PY - 2018/5/15

Y1 - 2018/5/15

N2 - Background: Pulmonary rehabilitation is an effective therapeutic intervention for people with chronic respiratory disease. However, fewer than 5% of eligible individuals receive pulmonary rehabilitation on an annual basis, largely due to limited availability of services and difficulties associated with travel and transport. The Rehabilitation Exercise At Home (REAcH) study is an assessor-blinded, multi-centre, randomised controlled equivalence trial designed to compare the efficacy of home-based telerehabilitation and traditional centre-based pulmonary rehabilitation in people with chronic respiratory disease. Methods: Participants will undertake an 8-week group-based pulmonary rehabilitation program of twice-weekly supervised exercise training, either in-person at a centre-based pulmonary rehabilitation program or remotely from their home via the Internet. Supervised exercise training sessions will include 30 min of aerobic exercise (cycle and/or walking training). Individualised education and self-management training will be delivered. All participants will be prescribed a home exercise program of walking and strengthening activities. Outcomes will be assessed by a blinded assessor at baseline, after completion of the intervention, and 12-months post intervention. The primary outcome is change in dyspnea score as measured by the Chronic Respiratory Questionnaire - dyspnea domain (CRQ-D). Secondary outcomes will evaluate the efficacy of telerehabilitation on 6-min walk distance, endurance cycle time during a constant work rate test, physical activity and quality of life. Adherence to pulmonary rehabilitation between the two models will be compared. A full economic analysis from a societal perspective will be undertaken to determine the cost-effectiveness of telerehabilitation compared to centre-based pulmonary rehabilitation. Discussion: Alternative models of pulmonary rehabilitation are required to improve both equity of access and patient-related outcomes. This trial will establish whether telerehabilitation can achieve equivalent improvement in outcomes compared to traditional centre-based pulmonary rehabilitation. If efficacious and cost-effective, the proposed telerehabilitation model is designed to be rapidly deployed into clinical practice.

AB - Background: Pulmonary rehabilitation is an effective therapeutic intervention for people with chronic respiratory disease. However, fewer than 5% of eligible individuals receive pulmonary rehabilitation on an annual basis, largely due to limited availability of services and difficulties associated with travel and transport. The Rehabilitation Exercise At Home (REAcH) study is an assessor-blinded, multi-centre, randomised controlled equivalence trial designed to compare the efficacy of home-based telerehabilitation and traditional centre-based pulmonary rehabilitation in people with chronic respiratory disease. Methods: Participants will undertake an 8-week group-based pulmonary rehabilitation program of twice-weekly supervised exercise training, either in-person at a centre-based pulmonary rehabilitation program or remotely from their home via the Internet. Supervised exercise training sessions will include 30 min of aerobic exercise (cycle and/or walking training). Individualised education and self-management training will be delivered. All participants will be prescribed a home exercise program of walking and strengthening activities. Outcomes will be assessed by a blinded assessor at baseline, after completion of the intervention, and 12-months post intervention. The primary outcome is change in dyspnea score as measured by the Chronic Respiratory Questionnaire - dyspnea domain (CRQ-D). Secondary outcomes will evaluate the efficacy of telerehabilitation on 6-min walk distance, endurance cycle time during a constant work rate test, physical activity and quality of life. Adherence to pulmonary rehabilitation between the two models will be compared. A full economic analysis from a societal perspective will be undertaken to determine the cost-effectiveness of telerehabilitation compared to centre-based pulmonary rehabilitation. Discussion: Alternative models of pulmonary rehabilitation are required to improve both equity of access and patient-related outcomes. This trial will establish whether telerehabilitation can achieve equivalent improvement in outcomes compared to traditional centre-based pulmonary rehabilitation. If efficacious and cost-effective, the proposed telerehabilitation model is designed to be rapidly deployed into clinical practice.

KW - Asthma

KW - Bronchiectasis

KW - Chronic obstructive pulmonary disease

KW - Exercise

KW - Interstitial lung disease

KW - Pulmonary rehabilitation

KW - Respiratory disease

KW - Telehealth

KW - Telerehabilitation

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U2 - 10.1186/s12890-018-0646-0

DO - 10.1186/s12890-018-0646-0

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