Telerehabilitation may be a feasible way to encourage exercise and improve physical functioning among those with cardiopulmonary disease

Hwang R, Bruning J, Morris N, et al.  A systematic review of the effects of telerehabilitation in patients with cardiopulmonary diseases  Journal of Cardiopulmonary Rehabilitation and Prevention. 2015 November:35(6)380-389

Review question

Can telerehabilitation programs improve the physical and functional outcomes of patients with cardiopulmonary disease as effectively as traditional, centre-based exercise programs?

Background

Patients with cardiopulmonary disease benefit from supervised exercise programs, but engagement in these programs remains low.

Telerehabilitation, or the delivery of rehabilitation programs by telephone, internet and videoconferencing, is used for patients with certain chronic diseases, but its applicability to cardiopulmonary disease is unclear.

Due to the success of telerehabilitation programs with other diseases, this therapy has the potential to benefit patients with cardiopulmonary disease.

How the review was done

A detailed search of a number of electronic databases for studies published from 1990 to 2013 was conducted. Studies that focused on home-based telerehabilitation, covered a minimum of two exercise sessions, and reported at least one physical or functional outcome related to cardiopulmonary disease, chronic heart failure, or chronic respiratory disease, were included in this review.

A total of 389 studies were identified in searches and 11 were included in the review after assessments for eligibility.

This review was funded by the Heart Foundation Health Professional Scholarship.

What the researchers found

Telerehabilitation was associated with high rates of adherence to exercise and considerable health improvements, such as increased quality of life and maximal oxygen uptake.

Several recommendations for the successful delivery of telerehabilitation emerged, such as comprehensive education for patients before the start of the program, having someone accompany the patient during exercise, and an initial home visit to identify possible barriers and risks associated with exercising at home.

The majority of studies used telephone-based telerehabilitation, and video and internet-based rehabilitation are yet to be thoroughly investigated.

Conclusion

The review found that telerehabilitation was just as effective as traditional, centre-based exercise programs in improving physical and functional outcomes in patients with cardiopulmonary disease. Due to the relatively low costs associated with telerehabilitation, it may be a feasible alternative to centre-based programs. More research is needed into all types of telerehabilitation before broad implementation can be considered.

This summary is based on a review that was determined to be of medium methodological quality based on an assessment using the AMSTAR tool.