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Randomized Controlled Trial
. 2025 Jan-Dec:22:14799731251318033.
doi: 10.1177/14799731251318033.

Remote assessment of exercise capacity in adults with chronic respiratory disease: Safety, reliability and acceptability

Narelle S Cox  1   2 , Simone Dal Corso  1 , Angela T Burge  1   2   3 , Janet Bondarenko  1   3 , Jaycie Perryman  1 , Anne E Holland  1   2   3
Affiliations
Randomized Controlled Trial

Remote assessment of exercise capacity in adults with chronic respiratory disease: Safety, reliability and acceptability

Narelle S Cox et al. Chron Respir Dis. 2025 Jan-Dec.

Abstract

Objectives: To assess the safety, reliability and acceptability of the modified incremental step test (MIST) supervised remotely via videoconferencing in adults with chronic respiratory disease.

Methods: Adults with chronic respiratory disease undertaking pulmonary rehabilitation were invited to undertake the MIST under two testing conditions: in-person supervision and remote supervision via video-conferencing. Test order was randomised.

Results: 38 participants (n = 18 Female; mean (SD) age 68 (10) years; 56% chronic obstructive pulmonary disease) undertook two MIST evaluations. There was excellent agreement between tests for total step count (ICC2,1 0.93, 95%CI 0.86 to 0.96), despite higher counts with in-person supervision (MD 12 steps, 95%CI 1 to 24). There was very good agreement, and no difference between tests, for nadir oxygen saturation (ICC2,1 0.797, 95%CI 0.643 to 0.889) and peak heart rate (ICC2,1 0.782, 95%CI 0.620 to 0.880). Participant satisfaction with telehealth was high, and confidence was not different between testing conditions. There were no adverse events and remote testing was acceptable to participants.

Discussion: In this single centre cohort study MIST supervised remotely via video-conferencing was safe, reliable and acceptable to people with chronic respiratory disease.

Keywords: COPD; Pulmonary rehabilitation; exercise testing; telehealth; telerehabilitation.

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Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Bland-Altman plots for agreement between A. Total steps; B. Nadir SpO2; C. Peak HR during MIST supervised remotely and in-person. Solid line represents the mean difference between testing occasions. The dashed lines represent the limits of agreement.
See this image and copyright information in PMC

References

    1. McCarthy B, Casey D, Devane D, et al. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2015; 2: 1. DOI: 10.1002/14651858.CD003793.pub3. - DOI - PMC - PubMed
    1. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med 2013; 188: e13-64. DOI: 10.1164/rccm.201309-1634ST. - DOI - PubMed
    1. Keating DT, Edgeworth D, Ellis M, et al. Improvement in exercise duration, lung function and well-being in G551D-Cystic Fibrosis patients: a double-blind, placebo-controlled, randomised, cross-over study with ivacaftor. Clin Sci 2017; 1: 1. DOI: 10.1042/CS20170995. - DOI - PubMed
    1. Cox NS, Oliveira CC, Lahham A, et al. Pulmonary rehabilitation referral and participation are commonly influenced by environment, knowledge, and beliefs about consequences: a systematic review using the Theoretical Domains Framework. J Physiother 2017; 63: 84–93. DOI: 10.1016/j.jphys.2017.02.002. - DOI - PubMed
    1. Marks G, Reddel H, Guevara-Rattray E, et al. Monitoring pulmonary rehabilitation and long-term oxygen therapy for people with COPD in Australia: a discussion paper. Canberra: Australian Institute for Health and Welfare, 2013.

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