• Age and ageing · Jan 2018

    Randomized Controlled Trial Multicenter Study

    Home-based telerehabilitation in older patients with chronic obstructive pulmonary disease and heart failure: a randomised controlled trial.

    • Palmira Bernocchi, Michele Vitacca, Maria Teresa La Rovere, Maurizio Volterrani, Tiziana Galli, Doriana Baratti, Mara Paneroni, Giuseppe Campolongo, Barbara Sposato, and Simonetta Scalvini.
    • Care Continuity Unit and Telemedicine Service, Istituti Clinici Scientifici Maugeri IRCCS, Lumezzane, Brescia, Italy.
    • Age Ageing. 2018 Jan 1; 47 (1): 82-88.

    Backgroundchronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently coexist in older people, reducing patients' quality of life (QoL) and increasing morbidity and mortality.Objectivewe studied the feasibility and efficacy of an integrated telerehabilitation home-based programme (Telereab-HBP), 4 months long, in patients with combined COPD and CHF. The primary outcome was exercise tolerance evaluated at the 6-min walk test (6MWT). Secondary outcomes were time-to-event (hospitalisation and death), dyspnoea (MRC), physical activity profile (PASE), disability (Barthel) and QoL (MLHFQ and CAT).Study Designrandomised, open, controlled, multicenter trial.Methodsthe Telereab-HBP included remote monitoring of cardiorespiratory parameters, weekly phone-calls by the nurse, and exercise programme, monitored weekly by the physiotherapist. All outcomes were studied again after 2 months of a no-intervention period.Resultsin total, 112 patients were randomised, 56 per group. Their mean (SD) age was 70 (9) years, and 92 (82.1%) were male. After 4 months, the IG were able to walk further than at baseline: mean (95% CI) Δ6MWT was 60 (22.2,97.8) m; the CG showed no significant improvement: -15 (-40.3,9.8) m; P = 0.0040 between groups. In IG, the media time to hospitalisation/death was 113.4 days compared with 104.7 in the CG (P = 0.0484, log-rank test). Other secondary outcomes: MRC (P = 0.0500), PASE (P = 0.0015), Barthel (P = 0.0006), MLHFQ (P = 0.0007) and CAT (P = 0.0000) were significantly improved in the IG compared with the CG at 4 months. IG maintained the benefits acquired at 6 months for outcomes.Conclusionsthis 4-month Telereab-HBP was feasible and effective in older patients with combined COPD and CHF.© The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

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