Investigating the safety, satisfaction and efficacy of pulmonary tele rehabilitation for people with respiratory conditions, including patients recovering from COVID-19.

Tele rehabilitation exercise training for patients with respiratory conditions All people who were referred to RPAH pulmonary rehab program were invited to attend the pulmonary tele rehabiltiation program even if they did not wish to participate in the study. Face to face pulmonary rehabilitation was suspended due to COVID-19. When face to face pulmonary rehabilitation returns, the tele rehabilitation program will remain as an option for patients who wish to exercise at home and who have technology. This study is a program review of routinely collected data Assessment: Full initial assessment was conducted via tele rehabilitation in a one to one session (40 minutes via zoom platform). Additional participant history was also extracted from SLHD electronic medical records (eMR). The initial assessment included medical history, collection of outcome measures (see below) and goal setting. The initial assessment allowed the main problems and comorbidities to be screened so the exercises could be individually tailored within the group class. The participant’s environment (including chair) was assessed for safety. It was not possible to collect data on six-minute walk distance, resting and end exercise oxygen saturation and heart rate via tele health. Final assessment (40 minutes via zoom platform) collected the same outcome measures as the initial assessment plus patients were asked to complete a satisfaction survey Exercise training: Participants then commenced the tele rehabilitation exercise training. Number of participants in each telerehab session ranged from one to ten. >Intensity: participants were asked work to a level of 3 to 4 on the modified BORG scale of dyspnoea. >Frequency/duration: participants could attend exercise training twice per week for eight weeks. Each class lasted 40 minutes. Seven classes were held each week with two slower paced groups for people using LTOT. >Monitoring: Close monitoring with instructions given by a physiotherapists sitting near the screen and another demonstrating the exercises so participants could easily follow >Attendance: an exercise checklist was marked for each exercise performed and each visit attended. The exercise training classes consisted of: >Warm up stretches that consisted of arm, leg and thoracic mobilisation >Strength training that consisted of sit to stand, squats, heel raises and arm weights (using available equipment e.g. water bottles and tin cans) and theraband if available >Aerobic training that consisted of marching on the spot, high knee walking, jogging and side stepping >Seated rests were interspersed with the exercise to allow breathless management and short recovery periods The education sessions were run weekly for 4 weeks with each session lasting 30 minutes. They were informal with questions and answers. The education topics focused on the management of breathlessness, exacerbations of the participant’s condition and COVID-19 concerns. Participants were asked to call the office if they had personal questions to ask or needed more information. Participants were reassessed via tele health after 16 sessions of tele rehab exercise training Data: will be collected retrospectively and prospectively - starting March 2020 when face to face pulmonary rehabiltiation was suspended. People will continue to choose to attend pulmonary tele rehabiltiation and so data collection will continue until early to middle 2021.