Vitacca Michele, Paneroni Mara, Saleri Manuela, Beccaluva Chiara Giuseppina
Respiratory Rehabilitation Unit, Istituti Clinici Scientifici Maugeri IRCCS, 25065 Lumezzane, Italy.
MedicAir Healthcare Telerehabilitation Service, 21140 Origgio, Italy.
Healthcare (Basel). 2024 Jul 9;12(14):1372. doi: 10.3390/healthcare12141372.
Maintenance strategies after center-based pulmonary rehabilitation (CBPR) are currently needed. This study aimed to evaluate the feasibility and effect on the quality of life of a home-based pulmonary rehabilitation (HBPR) program delivered by a digital app. As secondary objectives, the patients' adherence, symptoms, effort tolerance changes, and safety were evaluated. This was a single-arm prospective observational monocentric study on 30 patients referred for chronic respiratory diseases. The prescription and evaluations of the HBPR programs performed at the pulmonary facility and delivery of structured exercise and counselling by the digital health tool were achieved under the supervision of a respiratory therapist. Digital capabilities included aerobic, strength, and respiratory exercises, which were monitored with a fitness tracker. The engagement rate of the HBPR after the CBPR was 1:10. The EuroQoL VAS score increased from 66.2 ± 16.28 to 75.60 ± 16.07 ( < 0.001), mainly in younger subjects. No patient was lost during the HBPR program. The global adherence session rate was 94%. The Medical Research Council dyspnea scale (MRC), COPD Assessment Test (CAT) score, and six-minute walking test (6MWT) improved from admission into the pulmonary unit to the end of the HBPR program. Between the beginning and end of the CBPR, the CAT score decreased from 14.4 ± 6.39 to 8.50 ± 5.39 ( < 0.001), the MRC decreased from 1.87 ± 0.9 to 1.17 ± 0.83 ( < 0.001), and the 6MWT increased from 451 ± 93 to 473 ± 115 m ( < 0.05). The average Technology Acceptance Model score for usability was high (145 ± 12.1) and no adverse events occurred during the HBPR program. This HBPR model seemed to be feasible and well-accepted by patients, leading to improvements in quality of life, symptoms, and functional capacity.
目前需要基于中心的肺康复（CBPR）后的维持策略。本研究旨在评估通过数字应用程序提供的家庭肺康复（HBPR）计划的可行性及其对生活质量的影响。作为次要目标，评估了患者的依从性、症状、运动耐力变化和安全性。这是一项针对30例慢性呼吸道疾病患者的单臂前瞻性观察性单中心研究。在呼吸治疗师的监督下，在肺部设施进行HBPR计划的处方和评估，并通过数字健康工具提供结构化运动和咨询。数字功能包括有氧运动、力量训练和呼吸练习，通过健身追踪器进行监测。CBPR后的HBPR参与率为1:10。欧洲生活质量视觉模拟量表（EuroQoL VAS）评分从66.2±16.28提高到75.60±16.07（P<0.001），主要在年轻受试者中。在HBPR计划期间没有患者退出。总体依从性会话率为94%。从进入肺部病房到HBPR计划结束，医学研究委员会呼吸困难量表（MRC）、慢性阻塞性肺疾病评估测试（CAT）评分和六分钟步行试验（6MWT）均有所改善。在CBPR开始和结束之间，CAT评分从14.4±6.39降至8.50±5.39（P<0.001），MRC从1.87±0.9降至1.17±0.83（P<0.001），6MWT从451±93米增加到473±115米（P<0.05）。技术接受模型可用性平均得分较高（145±12.1），在HBPR计划期间未发生不良事件。这种HBPR模式似乎是可行的，并且被患者广泛接受，从而改善了生活质量、症状和功能能力。
