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The benefits of pulmonary rehabilitation for individuals with chronic respiratory diseases are well-documented1, but referral practices and programme completion have remained challenging. This has been exacerbated by the COVID-19 pandemic and shielding practices. Thus, highlighting the usefulness of developing a robust telerehabilitation programme as a substitute for centre-based programmes. The data gained from Cox et al addresses this area and demonstrates clinically meaningful advantages of telerehabilitation and is warmly welcomed. A detailed breakdown of the costs involved between both arms would be very helpful in assessing an overall equivalence of the two arms.
The CRQ is a validated tool for use in research; however, the use of its dyspnoea domain specifically has been shown to be less reliable in comparative research2. Other tools which may be a useful substitute for this study would be ‘incremental shuttle walking test’3 and ‘St George’s respiratory questionnaire’4.
The number of participants presenting to community healthcare services, and/or those requiring rescue therapy for a mild exacerbation (e.g., antibiotics and/or a short course of corticosteroids) not requiring presentation to a hospital, during the study and follow-up period, may be useful for further assessment of the equivalence of telerehabilitation versus centre-based programmes.
This study provides useful data regarding the potential benefits of incorporating telerehabilita...
This study provides useful data regarding the potential benefits of incorporating telerehabilitation programmes as a part of health services. Further information regarding costs, presentations to community services, and justification of the use of the CRQ-D tool would be valuable.
1. Bolton CE, Bevan-Smith EF, Blakey JD, et alBritish Thoracic Society guideline on pulmonary rehabilitation in adults: accredited by NICEThorax 2013;68:ii1-ii30.
2. Wijkstra PJ, TenVergert EM, Van Altena R, Otten V, Postma DS, Kraan J, Koëter GH. Reliability and validity of the chronic respiratory questionnaire (CRQ). Thorax. 1994 May;49(5):465-7. doi: 10.1136/thx.49.5.465. PMID: 8016767; PMCID: PMC474867.
3. Singh SJ, Jones PW, Evans R, Morgan MD. Minimum clinically important improvement for the incremental shuttle walking test. Thorax. 2008 Sep;63(9):775-7. doi: 10.1136/thx.2007.081208. Epub 2008 Apr 4. PMID: 18390634.
4. Paul W Jones (2005) St. George's Respiratory Questionnaire: MCID, COPD: Journal of Chronic Obstructive Pulmonary Disease, 2:1, 75-79, DOI: 10.1081/COPD-200050513