N/A
N=5
The Impact of a Home-based Pulmonary Telerehabilitation Program in Acute Exacerbations of COPD
Pulmonary Disease, Chronic Obstructive
Bottom Line
View on ClinicalTrials.gov: NCT03997513 ↗Enrolled (actual)
5
Serious AEs
0.0%
Results posted
Jul 2024
Primary outcome: Primary: Quadriceps Muscle Strength Testing Change
Study Design & Population
- Study type
- Interventional
- Phase
- N/A
- Interventions
- Pulmonary Telerehabilitation (Behavioral)
- Age
- Adult, Older Adult · 40+ yrs
- Sex
- All
- Sponsor
- VA Office of Research and Development
- Primary completion
- Jun 2022
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Quadriceps Muscle Strength Testing Change |
— | — |
| PRIMARY Six Minute Walk Test |
472; 48.25 | — |
| PRIMARY Health-related Quality of Life Assessments Change |
— | — |
| PRIMARY Participant Satisfaction Survey |
2; 2; 0; 2 | — |
| SECONDARY Sit-to-stand Test Change |
9.5; 5 | — |
| SECONDARY Handgrip Strength |
1.75; 0.5 | — |
| SECONDARY Disease Specific Quality of Life |
-.19; -17.8 | — |
| SECONDARY Symptoms During Sit-to-stand Test |
— | — |
| SECONDARY Post-intervention Survey |
— | — |
Summary
COPD impacts a significant proportion of the Veteran population. Acute exacerbations, or flare-ups, of COPD are associated with impaired muscle function and worse quality of life. Pulmonary rehabilitation, a formal exercise program for patients with lung disease that includes both endurance and strength training exercises, has been shown to improve muscle function and quality of life after an acute exacerbation of COPD. However, lack of geographically accessible rehabilitation facilities and/or transportation issues are often barriers to pulmonary rehabilitation attendance in the Veteran population. This study will assess the feasibility and impact of an eight-week, three sessions per week, home-based, pulmonary telerehabilitation program in Veterans with COPD following hospitalization for an acute exacerbation of their lung disease. We will measure adherence and satisfaction with the program and muscle strength, physical activity, quality of life, and exercise tolerance pre and post-intervention in Veterans randomized to the pulmonary telerehabilitation arm versus Veterans randomized to the control arm who do not participate in pulmonary rehabilitation.
Eligibility Criteria
Inclusion Criteria
- Veterans
- Moderate or severe COPD with a forced expiratory volume in 1 second - forced vital capacity ratio (FEV1/FVC) < 0.70 and FEV1 < 80% predicted
- Hospitalization with a primary diagnosis of AECOPD, defined as an increase in shortness of breath, cough, and/or sputum production beyond the normal day-to-day variation necessitating a change in regular medication when other causes of increased shortness of breath, cough, and/or sputum production have been ruled out
- Capable of operating a tablet independently with adequate vision and hearing
Exclusion Criteria
- Acute hypercapneic respiratory failure with a requirement for either non-invasive (i.e. bilevel positive airway pressure) or invasive mechanical ventilation during hospitalization
- Hospitalization < 72 hours
- A secondary diagnosis of acute congestive heart failure, myocardial infarction, or pneumonia during hospitalization or unstable cardiac or neurologic disease at discharge
- Enrollment in a pulmonary rehabilitation program within 12 months of hospitalization
- A medical condition that makes exercise unsafe (includes upper and lower limb strength training and lower limb cycle ergometry)
- This will be determined by the following- screen for these through chart review, discussion with the patient (do they have any known cardiac issues, do they have chest pain with exertion, are they lightheaded with exertion), discussion with the physicians caring for the patient in the hospital, and direct observation and assessment during the bedside pulmonary rehab sessions (that were built into this study for safety purposes)
- Inclusion in another greater than minimal risk study
Data sourced from ClinicalTrials.gov (NCT03997513). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.