Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Mar 11, 2021
Date Accepted: May 27, 2021
Date Submitted to PubMed: May 28, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Tele-rehabilitation during the COVID-19 pandemic: experience of a large lung transplant centre
ABSTRACT
Background:
The COVID-19 pandemic resulted in a rapid shift from centre-based to tele-rehabilitation. Clinical experience with this delivery model on a large scale has not been described.
Objective:
Describe usage and satisfaction of healthcare providers and lung transplant candidates and recipients and functional outcomes.
Methods:
A program evaluation of providers and lung transplant candidates and recipients who used a web-based, remote monitoring App for a least four weeks between March 16th and September 1st 2020. Within-subjects analysis was performed for physical activity and exercise volumes.
Results:
78 candidates and 33 recipients were included (50% male, 58 ± 12 years, 50% interstitial lung disease 31% chronic obstructive pulmonary disease). 83% of candidates agreed the App helped prepare them for surgery and 85% of recipients found the App helpful to their self-recovery. Physiotherapists reported satisfaction using the App to maintain communication, provide virtual support and monitor remotely. Patients accessed the App’s exercise card (278 views), exercise video (116 views) and guidelines for exercising after transplant (89 views). 26 candidates used a treadmill that increased in duration (16-22mins, P=.002) but not speed (1.7-1.75mph, P=.31). Quadriceps weight (lbs) for leg extension did not change (3.5[2.4-5] vs. 4.3[3-5] P=.08, n=37). Nine recipients used a treadmill that increased in speed (1.9 – 2.7mph, P=.003) up to three months post-transplant. Quadriceps weight (lbs) increased (3[0-3] vs. 5[3.8-6.5] P<.001, n=15). Three month post-transplant 6-minute walk distance was 62% ± 18% predicted (n=8).
Conclusions:
We were able to provide tele-rehabilitation despite challenges around exercise equipment. This early experience will inform the development of a robust and equitable tele-rehabilitation model beyond the COVID-19 pandemic.
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