Advanced telehealth technology improves home-based exercise therapy for people with stable chronic obstructive pulmonary disease: a systematic review

• Published in: Journal of physiotherapy 2021-01, Vol.67 (1), p.27-40
• Main Authors: Bonnevie, Tristan, Smondack, Pauline, Elkins, Mark, Gouel, Benoit, Medrinal, Clément, Combret, Yann, Muir, Jean-François, Cuvelier, Antoine, Prieur, Guillaume, Gravier, Francis-Edouard
• Format: Article
• Language: English
• Subjects: COPD; Exercise; Exercise Therapy; Exercise Tolerance; Humans; Meta-analysis; Pulmonary Disease, Chronic Obstructive - therapy; Pulmonary rehabilitation; Quality of Life; Technology; Telehealth; Telemedicine; Telerehabilitation
• ISSN: 1836-9553; 1836-9561
• DOI: 10.1016/j.jphys.2020.12.006

How effective is home-based exercise therapy delivered using advanced telehealth technology (ATT-ET) for people with chronic obstructive pulmonary disease (COPD) compared with: no exercise therapy (ET), in/outpatient ET, and home-based ET without ATT? Systematic review and meta-analysis of randomised trials. People with stable COPD referred for ET. ATT-ET. Exercise capacity, quality of life, functional dyspnoea, cost-effectiveness and various secondary outcomes. Fifteen eligible trials involved 1,522 participants. Compared with no ET, ATT-ET improved exercise capacity (four studies, 6-minute walk test MD 15 m, 95% CI 5 to 24) and probably improved quality of life (four studies, SMD 0.22, 95% CI 0.00 to 0.43) and functional dyspnoea (two studies, Chronic Respiratory Questionnaire-Dyspnoea MD 2, 95% CI 0 to 4). ATT-ET had a similar effect as in/outpatient ET on functional dyspnoea (two studies, SMD –0.05, 95% CI –0.39 to 0.29) and a similar or better effect on quality of life (two studies, SMD 0.23, 95% CI –0.04 to 0.50) but its relative effect on exercise capacity was very uncertain (three studies, 6-minute walk test MD 6 m, 95% CI –26 to 37). ATT-ET had a similar effect as home-based ET without ATT on exercise capacity (three studies, 6-minute walk test MD 2 m, 95% CI –16 to 19) and similar or better effects on quality of life (three studies, SMD 0.79, 95% CI –0.04 to 1.62) and functional dyspnoea (two studies, Chronic Respiratory Questionnaire-Dyspnoea MD 2, 95% CI 0 to 4). ATT-ET had effects on most secondary outcomes that were similar to or better than each comparator. ATT-ET improves exercise capacity, functional dyspnoea and quality of life compared with no ET, although some benefits may be small. Its benefits are generally similar to in/outpatient ET and similar to or better than home-based ET without ATT. PROSPERO CRD42020165773.