Background Many patients cannot attend group-based pulmonary rehabilitation programmes due to remoteness from the clinic or transport problems. We describe a feasibility study of a novel method of delivering a programme via internet-based videoconferencing.
Methods We re-boxed a mini PC in a simple case with a single large on/off button, which was connected to each patient's home television and wired to the Internet, together with a web cam, speakerphone, and, where appropriate, a wireless pulse oximeter. The physiotherapist delivered the programme from a central location equipped with a desktop PC connected to the internet; web cam; speakerphone and 40-in. video screen. When patients turned on their mini PC and TV and switched to the video channel, they automatically joined the class. All patients and the physiotherapist were visible and audible on all TV screens, to create a group spirit. A supporting screen was added to the physiotherapist's set-up to display patient names, exercise duration (30–60 s), pulse oximeter readings, and an exercise timer. A desktop video conferencing service was employed. A standard pulmonary rehabilitation exercise programme was delivered involving twice-weekly sessions for 8 weeks. Patients were assessed pre- and post-programme by Chronic Respiratory Questionnaire (CRQ), the Hospital Anxiety and Depression Scale (HADS) and an incremental shuttle-walking test. Satisfaction was measured using the Client Satisfaction Questionnaire (CSQ). Results are expressed as mean (SD). Four patients aged 65–79 enrolled for this feasibility study, which was approved by the North of Scotland Research Ethics Service.
Results All patients completed the programme. The technology performed well: one patient missed a single session due to a temporary problem connecting to the Internet. Clinical improvements occurred in all patients, comparable to those in a conventional programme. Compared to pre-programme values, there were improvements in: shuttle walking, 88 (35) m; CRQ dyspnoea 8 (5.2); emotion 2.8 (1); fatigue 5.3 (3.7) and mastery 4 (2.6). HADS anxiety and depression scores reduced in three of four patients. Satisfaction scores were high: CSQ values 29–32.
Conclusion The system allowed delivery of effective group-based pulmonary rehabilitation to patients in their own homes and should improve accessibility for future patients. Larger studies are warranted.