Palmira Bernocchi1, Michele Vitacca2, Maria Teresa La Rovere3, Maurizio Volterrani4, Tiziana Galli2, Doriana Baratti1, Mara Paneroni2, Giuseppe Campolongo4, Barbara Sposato4, Simonetta Scalvini1,5. 1. Care Continuity Unit and Telemedicine Service, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy. 2. Respiratory Rehabilitation Division, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy. 3. Cardiac Rehabilitation Division, Istituti Clinici Scientifici Maugeri IRCCS, Montescano, Pavia,Italy. 4. Cardiology Department, San Raffaele Pisana IRCCS, Roma, Italy. 5. Cardiac Rehabilitation Division, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy.
Abstract
Background: chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently coexist in older people, reducing patients' quality of life (QoL) and increasing morbidity and mortality. Objective: we studied the feasibility and efficacy of an integrated telerehabilitation home-based programme (Telereab-HBP), 4 months long, in patients with combined COPD and CHF. The primary outcome was exercise tolerance evaluated at the 6-min walk test (6MWT). Secondary outcomes were time-to-event (hospitalisation and death), dyspnoea (MRC), physical activity profile (PASE), disability (Barthel) and QoL (MLHFQ and CAT). Study design: randomised, open, controlled, multicenter trial. Methods: the Telereab-HBP included remote monitoring of cardiorespiratory parameters, weekly phone-calls by the nurse, and exercise programme, monitored weekly by the physiotherapist. All outcomes were studied again after 2 months of a no-intervention period. Results: in total, 112 patients were randomised, 56 per group. Their mean (SD) age was 70 (9) years, and 92 (82.1%) were male. After 4 months, the IG were able to walk further than at baseline: mean (95% CI) Δ6MWT was 60 (22.2,97.8) m; the CG showed no significant improvement: -15 (-40.3,9.8) m; P = 0.0040 between groups. In IG, the media time to hospitalisation/death was 113.4 days compared with 104.7 in the CG (P = 0.0484, log-rank test). Other secondary outcomes: MRC (P = 0.0500), PASE (P = 0.0015), Barthel (P = 0.0006), MLHFQ (P = 0.0007) and CAT (P = 0.0000) were significantly improved in the IG compared with the CG at 4 months. IG maintained the benefits acquired at 6 months for outcomes. Conclusions: this 4-month Telereab-HBP was feasible and effective in older patients with combined COPD and CHF.
RCT Entities:
Background: chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently coexist in older people, reducing patients' quality of life (QoL) and increasing morbidity and mortality. Objective: we studied the feasibility and efficacy of an integrated telerehabilitation home-based programme (Telereab-HBP), 4 months long, in patients with combined COPD and CHF. The primary outcome was exercise tolerance evaluated at the 6-min walk test (6MWT). Secondary outcomes were time-to-event (hospitalisation and death), dyspnoea (MRC), physical activity profile (PASE), disability (Barthel) and QoL (MLHFQ and CAT). Study design: randomised, open, controlled, multicenter trial. Methods: the Telereab-HBP included remote monitoring of cardiorespiratory parameters, weekly phone-calls by the nurse, and exercise programme, monitored weekly by the physiotherapist. All outcomes were studied again after 2 months of a no-intervention period. Results: in total, 112 patients were randomised, 56 per group. Their mean (SD) age was 70 (9) years, and 92 (82.1%) were male. After 4 months, the IG were able to walk further than at baseline: mean (95% CI) Δ6MWT was 60 (22.2,97.8) m; the CG showed no significant improvement: -15 (-40.3,9.8) m; P = 0.0040 between groups. In IG, the media time to hospitalisation/death was 113.4 days compared with 104.7 in the CG (P = 0.0484, log-rank test). Other secondary outcomes: MRC (P = 0.0500), PASE (P = 0.0015), Barthel (P = 0.0006), MLHFQ (P = 0.0007) and CAT (P = 0.0000) were significantly improved in the IG compared with the CG at 4 months. IG maintained the benefits acquired at 6 months for outcomes. Conclusions: this 4-month Telereab-HBP was feasible and effective in older patients with combined COPD and CHF.
Authors: Charlotte C Poot; Eline Meijer; Annemarije L Kruis; Nynke Smidt; Niels H Chavannes; Persijn J Honkoop Journal: Cochrane Database Syst Rev Date: 2021-09-08
Authors: Narelle S Cox; Simone Dal Corso; Henrik Hansen; Christine F McDonald; Catherine J Hill; Paolo Zanaboni; Jennifer A Alison; Paul O'Halloran; Heather Macdonald; Anne E Holland Journal: Cochrane Database Syst Rev Date: 2021-01-29
Authors: Emma J Dennett; Sadia Janjua; Elizabeth Stovold; Samantha L Harrison; Melissa J McDonnell; Anne E Holland Journal: Cochrane Database Syst Rev Date: 2021-07-26