Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, BC, Canada.
Division of Respiratory Medicine, University of British Columbia, Vancouver, BC, Canada.
Int J Chron Obstruct Pulmon Dis. 2021 Feb 19;16:379-391. doi: 10.2147/COPD.S263031. eCollection 2021.
Pulmonary rehabilitation (PR) is effective in reducing symptoms and improving health status, and exercise tolerance of patients with chronic obstructive pulmonary disease (COPD). The coronavirus disease 19 (COVID-19) pandemic has greatly impacted PR programs and their delivery to patients. Owing to fears of viral transmission and resultant outbreaks of COVID-19, institution-based PR programs have been forced to significantly reduce enrolment or in some cases completely shut down during the pandemic. As a majority of COPD patients are elderly and have multiple co-morbidities including cardiovascular disease and diabetes, they are notably susceptible to severe complications of COVID-19. As such, patients have been advised to stay at home and avoid social contact to the maximum extent possible. This has increased patients' vulnerability to physical deconditioning, depression, and social isolation. To address this major gap in care, some traditional hospital or clinic-centered PR programs have converted some or all of their learning contents to home-based telerehabilitation during the pandemic. There are, however, some significant barriers to this approach that have impeded its implementation in the community. These include variable access and use of technology (by patients), a lack of standardization of methods and tools for evaluation of the program, and inadequate training and resources for health professionals in optimally delivering telerehabilitation to patients. There is a pressing need for high-quality studies on these modalities of PR to enable the successful implementation of PR at home and via teleconferencing technologies. Here, we highlight the importance of telerehabilitation of patients with COPD in the post-COVID world and discuss various strategies for clinical implementation.
肺康复（PR）可有效减轻症状、改善健康状况和慢性阻塞性肺疾病（COPD）患者的运动耐量。COVID-19 大流行对 PR 计划及其向患者的提供产生了巨大影响。由于担心病毒传播和 COVID-19 的爆发，机构内 PR 计划被迫大幅减少招生，在大流行期间，在某些情况下完全关闭。由于大多数 COPD 患者年龄较大，且合并多种疾病，包括心血管疾病和糖尿病，他们极易受到 COVID-19 的严重并发症的影响。因此，建议患者尽可能呆在家里，避免社交接触。这增加了患者身体机能下降、抑郁和社会隔离的脆弱性。为了解决这一重大护理差距，一些传统的医院或诊所为中心的 PR 计划在大流行期间将部分或全部学习内容转换为基于家庭的远程康复。然而，这种方法存在一些重大障碍，阻碍了其在社区中的实施。这些障碍包括患者对技术的不同访问和使用（患者）、评估该计划的方法和工具缺乏标准化以及卫生专业人员在为患者提供最佳远程康复方面的培训和资源不足。迫切需要对这些 PR 模式进行高质量的研究，以便能够成功地在家中通过远程会议技术实施 PR。在这里，我们强调了在 COVID-19 后世界中对 COPD 患者进行远程康复的重要性，并讨论了各种临床实施策略。
