【論文摘要】Personalized Video-delivered Telerehabilitation Improves Qol, Muscle Strengths, Cardiopulmonary Functions and Compliance in Patients With COPD

【論文摘要】個人化影片之遠端復健模式改善慢性阻塞性肺部疾病患者的生活品質、肌肉力量、心肺功能以及復健配合度

林苡竹(Yi-Chu Lin) ； 洪菁霞(Ching-Hsia Hung)

《物理治療》 46卷2期 (2021/06) Pp. 124-125

https://doi.org/10.6215/FJPT.202106.P12

摘要

Background and Purpose: Chronic obstructive pulmonary disease (COPD) is the third global cause of deaths. Pulmonary rehabilitation (PR) is the standard treatment for this disease. However, the dropout rate remains high (33-50%) because of traffic issues and patients' low mobility. Therefore, telerehabilitation seems to be a better way to deliver PR. Using videos to deliver PR is not only easy to manipulate on the cellphone or ipad, but also improve patients' attention and compliance. Thus, the aim of this study is to assess whether tailor-made PR video rehabilitation program improves patients' quality of life (QoL), muscle strengths, cardiopulmonary functions, and compliance. Methods: This is a randomized controlled trial with 6-week follow-up. Participants were medically stable COPD patients and able to use LINE and YOUTUBE in cellphone. In the process of recruitment, they were all assessed by time-up-and-go test. The performance of time-up-and-go test should be lower than 12 seconds to rule out the participants with high risks of falling. They were randomly assigned to control group or intervention group to conduct 6-week home-based PR program. Patients in control group received the education booklet with words and pictures. Patients in intervention group watched YOUTUBE videos to rehab and recorded the intensity after the exercise by rating of perceived exertion (RPE) scores. During the intervention, a physical therapist would have weekly telephone calls or LINE calls for 6 times to monitor and modify the intensity of exercise. The videos included 5-minute breathing reeducation, 20-minute interval strengthening exercise, and 5-minute education animation. All patients were assessed the performance of spirometry, cardiopulmonary exercise test (CPET), questionnaires about symptoms, QoL, muscle strengths, and distances of 6-minute walk test (6MWT) before intervention, after intervention and, after 6-week follow-up. Results: After the 6-week intervention, the values of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), muscle strengths, and distances of 6MWT were increased. The total work (watts) and maximal oxygen uptake (VO2max) (mL/kg/min) in CPET were increased. The minute ventilation to carbon dioxide production slope (VE/VCO2) was decreased. The time point of anaerobic threshold (AT) after intervention was postponed because the PR program improved the utilization of aerobic metabolism. Conclusion: The video-delivered PR program is more convenience for COPD patient to carry out home-based PR. Also, the intervention will improve cardiopulmonary functions, QoL, and physical activity. Clinical Relevance: Our study provides an effective way to deliver home-based PR program that will improve multiple health-related functions and participation in COPD patients, decrease drop-out rate and potentially increase the utilization of PR.