Comparison of Telehealth and Onsite Supervised Maintenance Exercise Programs for Adults With Chronic Lung Disease: Protocol for a Pilot Randomized Feasibility Trial
Notice bibliographique
Résumé
BACKGROUND: Chronic lung diseases (CLDs) such as chronic obstructive pulmonary disease, interstitial lung disease, and chronic asthma contribute significantly to the global burden of disease. Pulmonary rehabilitation (PR) is an effective intervention for improving the exercise capacity, increasing the quality of life, and reducing hospitalizations in individuals with CLD. However, benefits from PR quickly decline following discharge from traditional programs. Telerehabilitation (tele-rehab) has emerged as a potential solution for extending the benefits of PR; yet, few studies have compared its efficacy with conventional onsite maintenance rehabilitation. OBJECTIVE: This pilot protocol aims to assess the effectiveness of an 8-week supervised maintenance rehabilitation program delivered onsite or remotely via tele-rehab in patients with CLD. METHODS: This randomized, assessor-blinded feasibility pilot trial will enroll 30 participants who have completed outpatient PR. Participants will be randomized into 2 groups: (1) tele-rehab, involving remotely supervised sessions conducted via videoconferencing or (2) onsite maintenance rehabilitation with in-person sessions. Both groups will receive weekly supervised sessions for 8 weeks facilitated by licensed physical therapists. Assessments will be conducted onsite at baseline, after the 8-week intervention, and at 1-month follow-up by a blinded assessor. The feasibility of the intervention and the study methods will be assessed by the log-in into the number of sessions attended after randomization, the ease of using the equipment and procedures, optimal session length, and adherence to the intervention protocol. Clinical outcomes will include dyspnea and perceived exertion, respiratory muscle strength, physical function, 6-minute walk distance, physical activity, and quality of life. Descriptive statistics with means and standard deviations for continuous and frequency distributions for categorical data will be utilized to report individual and group characteristics. Feasibility outcomes will be compared using independent 2-sided t tests. Between-group comparisons will use mixed analysis of variance, and within-group comparisons will be analyzed with a repeated measures analysis of variance. RESULTS: Recruitment for this institutional review board-approved study (approval date: July 25, 2023) began in January 2024, with 11 (37%) of the 30 participants enrolled to date. This study will generate data comparing tele-rehab and onsite rehabilitation in terms of the primary and secondary outcomes. Use data such as program adherence and attrition will also be reported. The results will inform the feasibility, adherence, and effectiveness of tele-rehab as a sustainable alternative to onsite maintenance rehabilitation. The study is anticipated to be completed by April 2026. CONCLUSIONS: This study hypothesizes that both tele-rehab and onsite programs will significantly improve clinical outcomes, with tele-rehab yielding comparable benefits to onsite maintenance. Findings will provide evidence supporting accessible and sustainable maintenance rehabilitation options for patients with CLD and guide future large-scale efficacy trials. TRIAL REGISTRATION: ClinicalTrials.gov NCT06304207; https://clinicaltrials.gov/study/NCT06304207. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/71039.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,031 | 0,025 |
| Méta-épidémiologie (sens strict) | 0,006 | 0,003 |
| Méta-épidémiologie (sens large) | 0,010 | 0,005 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,003 | 0,004 |
| Communication savante | 0,004 | 0,003 |
| Science ouverte | 0,004 | 0,002 |
| Intégrité de la recherche | 0,006 | 0,007 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,053 | 0,009 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».