Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Nov 17;19(22):15165.
doi: 10.3390/ijerph192215165.

Characteristics, Components, and Efficacy of Telerehabilitation Approaches for People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Sara Isernia  1 , Chiara Pagliari  1 , Luca Nicola Cesare Bianchi  1 , Paolo Innocente Banfi  1 , Federica Rossetto  1 , Francesca Borgnis  1 , Monica Tavanelli  1 , Lorenzo Brambilla  2 , Francesca Baglio  1 ; CPTM Group
Affiliations
Meta-Analysis

Characteristics, Components, and Efficacy of Telerehabilitation Approaches for People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

Sara Isernia et al. Int J Environ Res Public Health. .

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) is at the top of the list of non-communicable diseases with related rehabilitation needs. Digital medicine may provide continuative integrated intervention, overcoming accessibility and cost barriers.

Methods: We systematically searched for randomized controlled trials on telerehabilitation (TR) in people with COPD to profile the adopted TR strategies, focusing on TR models and the main rehabilitation actions: monitoring and assessment, decision, and feedback. Additionally, a meta-analysis was run to test the TR effect on functional capacity, dyspnea, and quality of life compared to no intervention (NI) and conventional intervention (CI).

Results: Out of the 6041 studies identified, 22 were eligible for the systematic review, and 14 were included in the meta-analyses. Results showed a heterogeneous scenario in terms of the TR features. Furthermore, only a small group of trials presented a comprehensive technological kit. The meta-analysis highlighted a significant effect of TR, especially with the asynchronous model, on all outcomes compared to NI. Moreover, a non-inferiority effect of TR on functional capacity and quality of life, and a superiority effect on dyspnea compared to CI were observed. Finally, the studies suggested a high rate of TR adherence and high safety level.

Conclusions: TR is an effective strategy to increase and maintain functional capacity, breath, and quality of life in people with COPD. However, a consensus on the essential elements and features of this approach needs to be defined, and the effect of long-term maintenance merits further investigation.

Keywords: chronic obstructive pulmonary disease; continuity of care; digital medicine; pulmonary; rehabilitation; telerehabilitation.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflict of interest concerning the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
2020 PRISMA Flow Diagram.
Figure 2
Figure 2
Forest plot on the effect of TR on functional capacity compared to NI. TR, TR; NI, no intervention [8,29,33,34,35,38,41]. Ref. [31] was not included in the analysis based on the leave-one-out analysis.
Figure 3
Figure 3
Forest plot of the effect of TR on functional capacity compared to conventional intervention. CI, conventional intervention; TR, TR [8,24,26,37].
Figure 4
Figure 4
Forest plot of the effect of TR on dyspnea compared to usual care. TR, TR; NI, no intervention [8,33,35,41]. Ref. [31] has not been included in the analysis based on the leave-one-out analysis.
Figure 5
Figure 5
Forest plot of the effect of TR on dyspnea compared to conventional intervention. CI, conventional intervention; TR, TR [8,24,25,26,30,36,37].
Figure 6
Figure 6
Forest plot of the effect of TR on quality of life compared to usual care. TR, TR; NI, no intervention [8,29,33,34,35,38,41]. Ref [31] was not included in this analysis based on the leave-one-out analysis.
Figure 7
Figure 7
Forest plot of the effect of TR on quality of life compared to conventional intervention. CI, conventional intervention; TR, TR [8,24,25,26,36,37].
See this image and copyright information in PMC

References

    1. Global Burden Disease Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet Respir. Med. 2020;8:585–596. doi: 10.1016/S2213-2600(20)30105-3. - DOI - PMC - PubMed
    1. Nugent R., Bertram M.Y., Jan S., Niessen L.W., Sassi F., Jamison D.T., Pier E.G., Beaglehole R. Investing in non-communicable disease prevention and management to advance the Sustainable Development Goals. Lancet. 2018;391:2029–2035. doi: 10.1016/S0140-6736(18)30667-6. - DOI - PubMed
    1. Lainscak M., Anker S.D. Heart failure, chronic obstructive pulmonary disease, and asthma: Numbers, facts, and challenges. ESC Heart Fail. 2015;2:103–107. doi: 10.1002/ehf2.12055. - DOI - PMC - PubMed
    1. Ryrsø C.K., Godtfredsen N.S., Kofod L.M., Lavesen M., Mogensen L., Tobberup R., Farver-Vestergaard I., Callesen H.E., Tendal B., Lange P., et al. Lower mortality after early supervised pulmonary rehabilitation following COPD-exacerbations: A systematic review and meta-analysis. BMC Pulm. Med. 2018;18:154. doi: 10.1186/s12890-018-0718-1. - DOI - PMC - PubMed
    1. Gee P.M., Greenwood D.A., Paterniti D.A., Ward D., Miller L.M. The eHealth Enhanced Chronic Care Model: A theory derivation approach. J. Med. Internet Res. 2015;17:e86. doi: 10.2196/jmir.4067. - DOI - PMC - PubMed

Publication types