Technology engagement in pulmonary rehabilitation
People with chronic lung disease (such as emphysema) experience shortness of breath, poor exercise capacity and reduced quality of life. Each of these problems can be combatted with a program of exercise and education known as pulmonary rehabilitation. Although many hospitals offer pulmonary rehabilitation programs, most suitable candidates do not attend (or attend but do not complete) the program. This situation can be attributed to various barriers, such as: travel time, travel costs, fatigue, inconvenience, and disruption to daily activities.
Novel methods of delivering pulmonary rehabilitation have been developed, such as using internet-based technologies to administer the program in the home, known as 'tele-rehabilitation'. There are various models of tele-rehabilitation, including: in-home videoconferencing, videoconferencing from a central centre to a satellite centre, mobile phone-based exercise programs, a combination of videoconferencing and telephone support, and web-based self-monitoring. Pulmonary tele-rehabilitation is of interest because it may increase convenient and equitable access to services, whilst reducing barriers associated with attending centre-based programs for people with chronic lung disease.
Substantial evidence now suggests that pulmonary tele-rehabilitation is as effective as face-to-face, hospital-based pulmonary rehabilitation. However, many hospitals have not implemented pulmonary tele-rehabilitation because of uncertainty about the willingness and ability of people with chronic respiratory disease (who are mainly older people) to use the technologies involved.
A recent multi-centre survey of pulmonary rehabilitation participants investigated their willingness and readiness to use the tele-rehabilitation format. The survey was high quality with a 100% response rate across 9 sites, giving a sample of over 250 respondents.
92% of respondents accessed at least one technological device, of whom 85% reported regularly using mobile phones and 70% regularly used a computer or tablet. 57% of respondents self-rated their technology skill competence as good and 60% were willing to use telerehabilitation.
This is good news for people with chronic lung disease, because it will encourage hospitals to invest in the infrastructure to offer pulmonary tele-rehabilitation, because they can expect an ongoing and growing proportion of candidates who will be willing (either immediately or after some training) to use that format.
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> From: Seidman, J Physiother 63 (2017) 175-181. All rights reserved to the Australian Physiotherapy Assocation. Click here for the online summary.