TELEREHABILITATION IN PULMONARY DISEASES

Öz

Lung diseases bring a huge burden on the health and social systems of countries. These diseases are the most common causes of morbidity and mortality. Chronic respiratory diseases take third place as the cause of death worldwide. People with chronic lung disease have dyspnea limiting the functional capacity, lower exercise tolerance, decrease in health-related quality of life, need for repeated hospitalization, higher prevalence of anxiety, and depression. The negative social and economic effects of chronic lung diseases are felt to a large extent by individuals, families, and communities, and these effects are expected to increase significantly in the future. Pulmonary rehabilitation is a proven and effective strategy to achieve clinically significant gains on functional capacity, symptoms and quality of life. Pulmonary rehabilitation should include an individually adapted exercise program, disease-specific training, and self-management skills. Although there is evidence for the benefit of pulmonary rehabilitation, very few people can be included in the rehabilitation program. With new pulmonary rehabilitation implementation strategies such as telerehabilitation, barriers to participation in center-based programs are reduced for people with chronic lung disease, while appropriate and equal access to services is provided. In addition to exercise training, telerehabilitation models may include other components of pulmonary rehabilitation, such as self-management training, disease management training, patient assessment, goal setting, monitoring of physiological signals, and peer support. Telerehabilitation allows more people to experience the benefits of pulmonary rehabilitation in people with lung disease to achieve greater participation, sustainable funds should be taken into consideration in telerehabilitation models. This review aims to examine the importance and effectiveness of telerehabilitation in the treatment of pulmonary diseases in the light of the relevant literature.

Anahtar Kelimeler

• Lung
• Pulmonary diseases
• Pulmonary rehabilitation
• Telerehabilitation

PULMONER HASTALIKLARDA TELEREHABİLİTASYON

Öz

Akciğer hastalıkları, ülkelerin sağlık ve sosyal sistemlerine büyük bir yük getirmektedir. Bu hastalıklar morbidite ve mortalitenin en yaygın nedenleri arasında yer almaktadır. Kronik solunumsal hastalıklar dünya çapında ölüm nedeni olarak üçüncü sırada yer almaktadır. Kronik akciğer hastalığı olan kişilerde; fonksiyonel kapasiteyi sınırlayan nefes darlığı, egzersiz toleransı düşüklüğü, sağlıkla ilgili yaşam kalitesinde bozulma, tekrarlı hastanede yatış ihtiyacı, anksiyete ve depresyon prevalansında artma görülür. Kronik akciğer hastalıklarının olumsuz sosyal ve ekonomik etkileri bireyler, aileler ve toplumlar tarafından büyük oranda hissedilmektedir ve gelecekte de bu etkilerin önemli ölçüde artacağı tahmin edilmektedir. Pulmoner rehabilitasyon, fonksiyonel kapasite, semptomlar ve yaşam kalitesi üzerinde klinik olarak önemli kazanımlar elde etmek için kanıtlanmış ve etkili bir stratejidir. Pulmoner rehabilitasyon, bireysel olarak uyarlanmış egzersiz programı, hastalığa özgü eğitim ve özyönetim becerilerini içermelidir. Pulmoner rehabilitasyonun yararına yönelik kanıtlar bulunmasına rağmen, çok az sayıda insan rehabilitasyon programına dahil olabilmektedir. Telerehabilitasyon gibi yeni pulmoner rehabilitasyon uygulama stratejileriyle, kronik akciğer hastalığı olan kişiler için merkez tabanlı programlara katılım engelleri azaltılırken, hizmetlere uygun ve eşit erişim sağlanır. Telerehabilitasyon modelleri egzersiz eğitimine ek olarak, öz-yönetim eğitimi, hastalık yönetimi ile ilgili eğitim, hasta değerlendirmesi, hedef belirleme, fizyolojik sinyallerin izlenmesi ve akran desteği gibi pulmoner rehabilitasyonun diğer bileşenlerini de içerebilir. Akciğer hastalığı olan kişilerde telerehabilitasyon, daha fazla insanın pulmoner rehabilitasyonun faydalarını deneyimlemesine olanak tanımaktadır. Daha büyük katılım sağlayabilmek için telerehabilitasyon modellerinde sürdürülebilir fonların dikkate alınması gerekmektedir. Bu derleme, pulmoner hastalıkların tedavisinde telerehabilitasyonun önemi ve etkinliğini ilgili literatür ışığında incelemeyi hedeflemektedir.

Anahtar Kelimeler

• Akciğer,
• Pulmoner hastalıklar,
• Pulmoner rehabilitasyon,
• Telerehabilitasyon

Kaynakça

1. 1. Cox NS, McDonald CF, Hill CJ, O’Halloran P, Alison JA, Zanaboni P, et al. Telerehabilitation for chronic respiratory disease. Cochrane Database of Systematic Reviews 2018(6):CD013040.
2. 2. Bousquet J, Dahl R, Khaltaev N. Global alliance against chronic respiratory diseases. Eur Respir J 2007;29:233–9.
3. 3. Ferkol T, Schraufnagel D. The global burden of respiratory disease. Annals of the American Thoracic Society 2014;11(3):404–6.
4. 4. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management and Prevention of COPD 2018. Available from: https://goldcopd.org/wp-content/uploads/2017/11/GOLD-2018-v6.0-FINAL-revised-20-Nov_WMS.pdf.
5. 5. Celli BR, MacNee W, Agusti A, Anzueto A, Berg B, Buist AS, et al. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. European Respiratory Journal 2004;23(6):932–46.
6. 6. Spruit MA, Singh SJ, Garvey C, ZuWallack R, Nici L, Rochester 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(8):e13–64.
7. 7. Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, Minson CT, Nigg CR, Salem GJ, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise 2009;41(7):1510–30.
8. 8. Collins EG, Langbein WE, Fehr L, O’Connell S, Jelinek C, Hagarty E, et al. Can ventilation-feedback training augment exercise tolerance in patients with chronic obstructive pulmonary disease? Am J Respir Crit Care Med 2008;177(8):844–52.

9. 9. Brooks D, Sottana R, Bell B, Hanna M, Laframboise L, Selvanayagarajah S, et al. Characterization of pulmonary rehabilitation programs in Canada in 2005. Canadian Respir J. 2007;14(2):87–92.
10. 10. Keating A, Lee A, Holland AE. What prevents people with chronic obstructive pulmonary disease from attending pulmonary rehabilitation? A systematic review. Chron Resp Dis 2011;8(2):89–99.
11. 11. Cox NS, Oliveira CC, Lahham A, Holland AE. 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(2):84–93.
12. 12. Johnston CL, Maxwell LJ, Maguire GP, Alison JA. How prepared are rural and remote health care practitioners to provide evidence-based management for people with chronic lung disease? Aust J Rural Health 2012;20(4):200–7.
13. 13. Rochester CL, Vogiatzis I, Holland AE, Lareau SC, Marciniuk DD, Puhan MA, et al. An official American Thoracic Society/European Respiratory Society policy statement: enhancing implementation, use, and delivery of pulmonary rehabilitation. Am J RespirCrit Care Med 2015;192(11):1373–86.
14. 14. Seidman Z, McNamara R, Wootton S, Leung R, Spencer L, Dale M, et al. People attending pulmonary rehabilitation demonstrate a substantial engagement with technology and willingness to use telerehabilitation: a survey. J Physiother 2017;63(3):175-81.
15. 15. American Thoracic Society (ATS). Holland AE, Cox NS. Telerehabilitation for people with chronic lung disease. Available from: https://www.thoracic.org/members/assemblies/assemblies/pr/quarterly-bite/telerehabilitation-for-people-with-chronic-lung-disease.php.
16. 16. Stickland M, Jourdain T, Wong EY, Rodgers WM, Jendzjowsky NG, Macdonald GF. Using Telehealth technology to deliver pulmonary rehabilitation in chronic obstructive pulmonary disease patients. Canadian Respiratory Journal 2011;18(4):216-20.
17. 17. Tsai LL, McNamara RJ, Moddel C, Alison JA, McKenzie DK, McKeough ZJ. Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: The randomized controlled TeleR Study. Respirology 2017;22(4):699-707.
18. 18. Vasilopoulou M, Papaioannou AI, Kaltsakas G, Louvaris Z, Chynkiamis N, Spetsioti S, et al. Home-based maintenance tele-rehabilitation reduces the risk for acute exacerbations of COPD, hospitalisations and emergency department visits. Eur Respir J 2017;49(5):1602129.
19. 19. Bernocchi P, Vitacca M, La Rovere MT, Volterrani M, Galli T, Baratti D, et al. Home-based telerehabilitation in older patients with chronic obstructive pulmonary disease and heart failure: a randomised controlled trial. Age Ageing 2018; 47(1): 82-8.
20. 20. Bourne S, DeVos R, North M, Chauhan A, Green B, Brown T, et al. Online versus face-to-face pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: randomised controlled trial. BMJ Open 2017;7(7):e014580.
21. 21. Chaplin E, Hewitt S, Apps L, Bankart J, Pulikottil-Jacob R, Boyce S, et al. Interactive web- based pulmonary rehabilitation programme: a randomised controlled feasibility trial. BMJ Open 2017;7(3):e013682.
22. 22. Hayton C, Clark A, Olive S, Browne P, Galey P, Knights E, et al. Barriers to pulmonary rehabilitation: Characteristics that predict patient attendance and adherence. Respir Med 2013;107(3):401-7.
23. 23. Marquis N, Larivée P, Saey D, Dubois MF, Tousignant M. In-home pulmonary telerehabilitation for patients with chronic obstructive pulmonary disease: A Pre-experimental study on effectiveness, satisfaction, and adherence. Telemed J E Health 2015;21(11):870-9.
24. 24. Liu XL, Tan JY, Wang T, Zhang Q, Zhang M, Yao LQ, et al. Effectiveness of home-based pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: A meta-analysis of randomized controlled trials. Rehabil Nurs 2014;39(1):36-59.
25. 25. Paneroni M, Colombo F, Papalia A, Colitta A, Borghi G, Saleri M, et al. Is telerehabilitation a safe and viable option for patients with COPD? A feasibility study. COPD 2015;12(2):217-25.
26. 26. Hoaas H, Andreassen HK, Lien LA, Hjalmarsen A, Zanaboni P. Adherence and factors affecting satisfaction in long-term telerehabilitation for patients with chronic obstructive pulmonary disease: A mixed methods study. BMC Med Inform Decis Mak 2016;16:26.
27. 27. Tousignant M, Marquis N, Pagé C, Imukuze N, Métivier A, St-Onge V, et al. In-home telerehabilitation for older persons with chronic obstructive pulmonary disease: A Pilot study. Int J Telerehabil 2012;4(1):7-14.
28. 28. Bairapareddy KC, Chandrasekaran B, Agarwal U. Telerehabilitation for Chronic Obstructive Pulmonary Disease Patients: An Underrecognized Management in Tertiary Care. Indian J Palliat Care 2018;24(4):529-33.
29. 29. dos Santos MT, Moura SC, Gomes LM, Lima AH, Moreira RS, Silva CD, et al. Telehealth application on the rehabilitation of children and adolescents. Rev Paul Pediatr 2014;32(1):136-43.
30. 30. Guendelman S, Meade K, Chen YQ, Benson M. Asthma control and hospitalizations among inner-city children: results of a randomized trial. Telemed J E Health 2004;10 (Suppl 2):S6-14.
31. 31. Jan RL, Wang JY, Huang MC, Tseng SM, Su HJ, Liu LF. An internet-based interactive telemonitoring system for improving childhood asthma outcomes in Taiwan. Telemed J E Health 2007;13(3):257-68.
32. 32. Chen JJ, Cooper DM, Haddad F, Sladkey A, Nussbaum E, Radom-Aizik S. Tele-Exercise as a Promising Tool to Promote Exercise in Children With Cystic Fibrosis. Front Public Health 2018;6:269.
33. 33. Choi J, Hergenroeder AL, Burke L, Dabbs AD, Morrell M, Saptono A, et al. Delivering an in-Home Exercise Program via Telerehabilitation: A Pilot Study of Lung Transplant Go (LTGO). Int J Telerehabil 2016;8(2):15-26.
34. 34. Coats V, Maltais F, Tremblay L, Saey D. Exercise-Based Rehabilitation for People with Lung Cancer. J Pulm Respir Med 2014;4:183.
35. 35. Chan C, Yamabayashi C, Syed N, Kirkham A, Camp PG. Exercise telemonitoring and telerehabilitation compared with traditional cardiac and pulmonary rehabilitation: a systematic review and meta-analysis. Physiother Can 2016;68(3):242–51.
36. 36. Hwang R, Bruning J, Morris N, Mandrusiak A, Trevor R. A systematic review of the effects of telerehabilitation in patients with cardiopulmonary diseases. J Cardiopulm Rehabil 2015;35(6):380–89.
37. 37. Gáldiz Iturri JB, Gorostiza Manterola A, Marina Malanda N. Telerehabilitation: An Effective Strategy in Pulmonary Rehabilitation Programs? Arch Bronconeumol 2018; 54(11):547-48.