Are Improvements Maintained After In-home Pulmonary Telerehabilitation for Patients with Chronic Obstructive Pulmonary Disease?

Authors

  • Nicole Marquis Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Université de Sherbrooke
  • Pierre Larivée Respiratory division, Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke
  • Marie-France Dubois Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Université de Sherbrooke
  • Michel Tousignant Research Centre on Aging, University Institute of Geriatrics of Sherbrooke, Université de Sherbrooke

DOI:

https://doi.org/10.5195/ijt.2014.6156

Abstract

This study investigated if improvements can be maintained over 24 weeks when in-home pulmonary telerehabilitation is combined with asynchronous self-management education for Chronic Obstructive Pulmonary Disease (COPD). Twenty-three community-living elders with moderate to very severe COPD participated in a pre/post-intervention study. Over 8 weeks, they had access to self-learning capsules on self-management, received 15 in-home teletreatment sessions and were encouraged to gradually engage in unsupervised sessions. Participants were assessed before the intervention (T1), immediately after the intervention (T2), and 6 months later (T3). Outcome measures were 1) exercise tolerance (6-minute walk test [6MWT]), Cycle Endurance Test [CET]), and 2) quality of life (Chronic Respiratory Questionnaire [CRQ]). Although there were significant improvements after 8 weeks of pulmonary telerehabilitation on the 6MWT, CET and three of four CRQ domains, none of these improvements were maintained after 6 months and scores returned to their baseline values (all p values > 0.05 when comparing T3 with T1).  While pulmonary telerehabilitation is possible and has a positive impact on patients with moderate to very severe COPD, improvements were not maintained in the long-term even when physical therapy was accompanied by self-management education. 

  

References

Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84, 191-215.

Bandura, A. (2007). Auto-efficacité : Le sentiment d'efficacité personnelle (2nd ed.). Paris: De Boeck.

Benzo, R., Vickers, K., Ernst, D., Tucker, S., McEvoy, C., & Lorig, K. (2013). Development and feasibility of a self-management intervention for chronic obstructive pulmonary disease delivered with motivational interviewing strategies. Journal of Cardiopulmonary Rehabilitation and Prevention, 33, 113-123.

Bourbeau, J. (2010). Making pulmonary rehabilitation a success in COPD. Swiss Medical Weekly, 140, e1-e8.

Bourbeau, J. (2012, mai). La réadaptation pulmonaire au Québec "D'hier à demain". Présentation faite pour le Réseau Québécois de l'Asthme et de la MPOC (RQAM). Paper presented at the Présentation faite pour le Réseau Québécois de l'Asthme et de la MPOC (RQAM).

Bourbeau, J., Julien, M., Maltais, F., Rouleau, M., Beaupré, A., Bégin, R., … Collet, J. (2003). Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: A disease-specific self-management intervention. Archives of Internal Medicine, 163, 585-591.

Bourbeau, J., Maltais, F., Rouleau, M., & Guimont, C. (2004). French-Canadian version of the Chronic Respiratory and St George's Respiratory questionnaires: An assessment of their psychometric properties in patients with chronic obstructive pulmonary disease. Canadian Respiratory Journal, 11, 480-486.

Bourbeau, J., & Nault, D. (2007). Self-management strategies in chronic obstructive pulmonary disease. Clinics in Chest Medicine, 28, 617-628.

Bourbeau, J., Nault, D., Parenteau, S., Bernard, S., Desgagné, P., Devost, A., . . . Frennete, J. (2009). Mieux vivre avec une maladie pulmonaire obstructive chronique (MPOC) Un plan d'action pour la vie Intégrer un programme d'exercices dans votre vie: RQAM Editor.

Bourbeau, J., & van der Palen, J. (2009). Promoting effective self-management programmes to improve COPD. European Respiratory Journal, 33, 461-463.

Casaburi, R. (2005). Factors determining constant work rate exercise tolerance in COPD and their role in dictating the minimal clinically important difference in response to interventions. COPD, 2, 131-136.

Casaburi, R., & Porszasz, J. (2009). Constant work rate exercise testing: A tricky measure of exercise tolerance. COPD, 6, 317-319.

Celli, B. R., Cote, C. G., Marin, J. M., Casanova, C., Montes de Oca, M., Mendez, R. A., . . . Cabral, H. J. (2004). The body-mass index airflow obstruction dyspnea and exercise capacity index in chronic obstructive pulmonary disease. New England Journal of Medicine, 350, 1005-1012.

Effing, T. W., Bourbeau, J., Vercoulen, J., Apter, A. J., Coultas, D., Meek, P., . . . Palen, J. (2012). Self-management programmes for COPD: Moving forward. Chronic Respiratory Disease, 9, 27-35.

Jones, N., Makrides, L., Hitchcock, C., Chypchar, T., & McCartney, N. (1985). Normal standards for an incremental progressive cycle ergometer test. American Review of Respiratory Disease, 131, 700-708.

Labrecque, M., Rabhi, K., Laurin, C., Favreau, H., Moullec, G., Lavoie, K., & Julien, M. (2011). Can a self-management education program for patients with chronic obstructive pulmonary disease improve quality of life? Canadian Respiratory Journal, 18, e77-e81.

Lacasse, Y., Maltais, F., & Goldstein, R. S. (2004). Pulmonary rehabilitation: An integral part of the long-term management of COPD. Swiss Medical Weekly, 134, 601-605.

Lacasse, Y., Martin, S., Lasserson, T. J., & Goldstein, R. S. (2007). Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease: A Cochrane systematic review. Europa Medicophysica, 43, 475-485.

Lacasse, Y., Wong, E., Guyatt, G. H., King, D., Cook, D. J., & Goldstein, R. S. (1996). Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease. Lancet, 348, 1115-1119.

Laviolette, L., Bourbeau, J., Bernard, S., Lacasse, Y., Pepin, V., Breton, M., . . . Maltais, F. (2008). Assessing the impact of pulmonary rehabilitation on functional status in COPD. Thorax, 63, 115-121.

Lorig, K. R., & Holman, H. (2003). Self-management education: History definition outcomes and mechanisms. Annals of Behavioral Medicine, 26, 1-7.

Lorig, K. R., Ritter, P. L., Laurent, D. D., & Plant, K. (2006). Internet-based chronic disease self-management: A randomized trial. Medical Care, 44, 964-971.

Maltais, F., Bourbeau, J., Shapiro, S., Lacasse, Y., Perrault, H., Baltzan, M., . . . Bernard, S. (2008). Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: A randomized trial. Annals of Internal Medicine, 149, 869-878.

Marquis, N., Larivée, P., Saey, D., Dubois, M.-F., & Tousignant, M. (2015; accepted). In-home pulmonary telerehabilitation for patients with Chronic Obstructive Pulmonary Disease (COPD): A pre-experimental study on effectiveness satisfaction and adherence. Telemedicine and e-Health.

Moroz, M. S. A. (2007). La prise en charge de la maladie chronique. Améliorer les soins prodigués aux patients souffrant de maladies chroniques: modèle de soins de longue durée. Actualités de réadaptation cardiaque et de prévention de la maladie cardiovasculaire, 15, 1-4.

Nguyen, H. Q., Carrieri-Kohlman, V., Rankin, S. H., Slaughter, R., & Stulbarg, M. S. (2005). Is Internet-based support for dyspnea self-management in patients with chronic obstructive pulmonary disease possible? Results of a pilot study. Heart & Lung : The Journal of Critical Care, 34, 51-62.

Nguyen, H. Q., Donesky-Cuenco, D., Wolpin, S., Reinke, L. F., Benditt, J. O., Paul, S. M., & Carrieri-Kohlman, V. (2008). Randomized controlled trial of an Internet-based versus face-to-face dyspnea self-management program for patients with chronic obstructive pulmonary disease: pilot study. Journal of Medical Internet Research, 10, e9.

O'Donnell, D. E., Hernandez, P., Kaplan, A., Aaron, S., Bourbeau, J., Marciniuk, D., . . . Voduc, N. (2008). Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease - 2008 update - highlights for primary care. Canadian Respiratory Journal, 15(Suppl A), 1A-8A.

Rasekaba, T., Lee, A. L., Naughton, M. T., Williams, T. J., & Holland, A. E. (2009). The six-minute walk test: A useful metric for the cardiopulmonary patient. Internal Medicine Journal, 39, 495-501.

Ries, A., Kaplan, R., Limberg, T., & Prewitt, L. (1995). Effects of pulmonary rehabilitation on physiologic and psychosocial outcomes in patients with chronic obstructive pulmonary disease. Annals of Internal Medicine, 122, 823-832.

Shadish, W. R., Cook, T. D., & Cambell, D. T. (2002). Experimental and quasi-experimental designs for generalized causal inference. Boston. MA, U.S.A.: Houghton Mifflin Company.

Spruit, M. A., Singh, S. J., Garvey, C., ZuWallack, R., Nici, L., Rochester, C., . . . Rehabilitation, A.E.T.F.o.P. (2013). An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine, 188, e13-64.

Stickland, M., Jourdain, T., Wong, E. Y., Rodgers, W. M., Jendzjowsky, N. G., & Macdonald, G. F. (2011). Using telehealth technology to deliver pulmonary rehabilitation in chronic obstructive pulmonary disease patients. Canadian Respiratory Journal, 18, 216-220.

Strijbos, J. H., Postma, D. S., van Altena, R., Gimeno, F., & Koëter, G. H. (1996). A comparison between an outpatient hospital-based pulmonary rehabilitation program and a home-care pulmonary rehabilitation program in patients with COPD: A follow-up of 18 months. Chest, 109, 366-372.

Tousignant, M., Boissy, P., Corriveau, H., & Moffet, H. (2006). In home telerehabilitation for older adults after discharge from an acute hospital or rehabilitation unit: A proof-of-concept study and costs estimation. Disability and Rehabilitation: Assistive Technology, 1, 209-216.

Tousignant, M., Moffet, H., Boissy, P., Corriveau, H., Cabana, F., & Marquis, F. (2009). In home telerehabilitation for post-knee artroplasty: A pilot study. International Journal of Telerehabilitation, 1(1), 9-16.

Tousignant, M., Moffet, H., Boissy, P., Corriveau, H., Cabana, F., & Marquis, F. (2011). A randomized controlled trial of home telerehabilitation for post-knee arthroplasty. Journal of Telemedicine and Telecare, 17, 195-198.

Tousignant, T., Marquis, N., Pagé, C., Imukuse, N., Metivier, A., St-Onge, V., & Tremblay, A. (2012). In-home telerehabilitation for older persons with chronic obstructive pulmonary disease: A pilot study. International Journal of Telerehabilitation, 4(1), 7-13.

Weingarten, S. R., Henning, J. M., Badamgarav, E., Knight, K., Hasselblad, V., Gano, A., & Ofman, J. J. (2002). Interventions used in disease management programmes for patients with chronic illness-which ones work? Meta-analysis of published reports. British Medical Journal (clinical research ed.), 325, 925.

Wijkstra, P. J., Ten Vergert, E. M., van Altena, R., Otten, V., Kraan, J., Postma, D. S., & Koëter, G. H. (1995). Long term benefits of rehabilitation at home on quality of life and exercise tolerance in patients with chronic obstructive pulmonary disease. Thorax, 50, 824-828.

Published

2015-01-29

How to Cite

Marquis, N., Larivée, P., Dubois, M.-F., & Tousignant, M. (2015). Are Improvements Maintained After In-home Pulmonary Telerehabilitation for Patients with Chronic Obstructive Pulmonary Disease?. International Journal of Telerehabilitation, 6(2), 21–30. https://doi.org/10.5195/ijt.2014.6156

Issue

Section

Research

Most read articles by the same author(s)