Eighty-three percent of participants (40 out of 48) completed the intervention in a study comparing virtual and center-based pulmonary rehabilitation.
A home-based virtual pulmonary rehabilitation (V-PR) program, supported by remote monitoring, was evaluated against traditional center-based rehabilitation (C-PR).
Adherence to the exercise program and educational offerings exceeded 80% in both the V-PR and C-PR groups.
Participants using the virtual platform reported high usability scores for the software.
Significant improvements were observed in walking distance during the for participants in both groups.
Health-related quality of life scores improved significantly for both groups, as measured by the CAT and SGRQ.
No adverse events occurred in either the virtual or center-based rehabilitation groups.
Simplified
OBJECTIVE: Fewer than 3% of adults with (COPD) attend in-person, center-based pulmonary rehabilitation (PR) despite demonstrated health benefits and reduction in mortality. This study evaluated the feasibility and usability of a novel home-based, virtual PR (V-PR) intervention compared to center-based PR (C-PR). The virtual PR intervention was supported by remote therapeutic monitoring (V-PR+RTM; Blue Marble Platform, Blue Marble Health, Altadena, CA). Additionally, we collected data on the to explore the efficacy of the V-PR compared to C-PR.
PATIENTS AND METHODS: Adults with stable COPD referred for PR were recruited. The participants self-selected C-PR or V-PR and were provided a 6-8-week personalized exercise and COPD self-management educational program. In addition, weekly phone contacts with the V-PR group were made. Feasibility was measured using qualitative analysis of adherence, reasons for withdrawal, and self-reported barriers to using the software at home. Usability was measured with the System Usability Scale (SUS). Efficacy was evaluated with the 6 minute Walk Test (6MWT) and various functional performance and patient-centered health-related quality of life (HRQoL) questionnaires.
RESULTS: Forty-eight participants were enrolled, and 40 (83.3%) completed the intervention, n=17 in the C-PR group and n=23 in the V-PR group. Four participants from each group withdrew due to reasons related to health issues (appendicitis, thrush, COVID, back pain) or the health status of their spouse, no-shows, and time constraints. Adherence to the exercise dose (3x/week) and educational offerings were >80% in both groups. Participants in the V-PR group scored the software as having high usability. In both groups, 6MWT distance improved significantly, as did scores on the CAT and SGRQ. No adverse events were reported in either group.
CONCLUSION: A software-enabled virtual PR program with remote therapeutic monitoring is feasible, usable, and effective. It could offer an alternative model that increases PR uptake for those unable or unwilling to attend in-person, center-based PR.
Key numbers
40 of 48 participants
Completion Rate
Participants who completed the intervention
34.0 meters
Mean Improvement in
Change in walking distance for the V-PR group post-intervention
84.1
Usability Score Improvement
Post-intervention System Usability Scale score for the V-PR software
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SF is the founder and CEO of Blue Marble Health. SF did not participate in the data collection of this study. CLM reports grants from Blue Marble Rehab, Inc, during the conduct of the study; research funding unrelated to this project from the American Lung Association, The Lang Family COPD Research Fund, Patient-Centered Outcomes Research Institute, AstraZeneca, and the National Institute on Aging/National Institutes of Health from R03AG082878-01 (GEMSSTAR award); grants from RofLumilast or Azithromycin to preveNt COPD Exacerbations (RELIANCE) (PCORI funded), A Phase III, Multicentre, Randomised, Double-blind, Chronic Dosing, Parallel Group, Placebo Controlled Study to Evaluate the Efficacy and Safety of Two Dose Regimens of MEDI3506 (AstraZeneca); personal fees from COPD Foundation, International Consulting Associates, Inc., Guidepoint, Physicians Education Resources, LLC, Wellinks, GlaxoSmithKline; travel reimbursement and honoraria from Respiratory Care Foundation, outside the submitted work. JO has received research funding from BI, TEVA, The Moore Foundation, The COPD Foundation, and NIH-Spiromics, as well as consulting fees from Theravance, Viatris, Chiesi Pharma, Astra Zeneca, Verona, Mylan, Genetech, and several law firms. NM reports personal fees from Inogen and Insprx. JD has received consulting fees from Medline Industries and educational fees from MedBridge. All remaining authors received funding from the NIH/NHLBI grant. The authors report no other conflicts of interest in this work.
