Evaluating Virtual and Inpatient Pulmonary Rehabilitation Programs for Patients with COPD

Chronic obstructive pulmonary disease (COPD) is an increasingly frequent disorder that is likely to become the third leading cause of morbidity worldwide. It significantly degrades the quality of life of patients affected and poses a significant financial burden to the healthcare systems providing treatment and rehabilitation. Consequently, our study's purpose was to compare conventional inpatient pulmonary rehabilitation (PR) with virtual (online) PR using a mobile phone application. During a three-month period, two groups of patients followed the research protocol by participating in a pulmonary rehabilitation program administered and supervised by a physical therapist five times per week. A number of respiratory variables were examined before and after the test. At the end of the study period, a total of 72 patients completed the rehabilitation in the inpatient group, respectively 58 in the online group. It was observed that post-test comparison between patients undergoing the traditional and online rehabilitation methods did not show any significant differences. However, the calculated mean differences between pre-test and post-test results were significantly higher in favor of the virtual method. The most significant variations were encountered in maximal inspiratory pressure (MIP) (6.6% vs. 8.5%, p-value < 0.001), 6-min walking test (6MWT) (6.7% vs. 9.4%, p-value < 0.001), and COPD assessment test (CAT) values (4.8 vs. 6.2, p-value < 0.001), respectively. However, the maximal expiratory pressure (MEP) variation was significantly higher in patients undergoing the traditional rehabilitation method, from an average of 4.1% to 3.2% (p-value < 0.001). In this preliminary study, the online pulmonary rehabilitation program proved non-inferiority to the traditional method, with significantly better results in several measurements. Additional studies using larger cohorts of patients and longer exposure to the online rehabilitation program are required to validate these findings.