There has been a lot of research on the use of home-based programs for cardio-pulmonary rehab in the COVID-19 pandemic era. This research has found several benefits of rehab by telemedicine compared to the center-based, traditional systems of rehab.
Cardiopulmonary rehab has been found to have proven benefits for patients with Cardiac issues or COPD (Chronic Obstructive Pulmonary Disease). But there are still many challenges due to a referral rate of only around 10%. Additionally, patients from socio-economically disadvantaged backgrounds have even lower rates of referral.
Also, less than 5% of patients who were hospitalized for acute exacerbation in COPD received pulmonary rehabilitation within 90 days of discharge, and less than 50% of referred patients enrolled and took part, as per research before the pandemic era.
Virtual Cardiac Rehab
According to the trend reported by The American Heart Association, remote or virtual cardiac rehab using teleconsultation with specialists through mobile devices like smartphones and tablets was equally effective as on-site programs offered in hospitals. Cardiac rehab is an outpatient, standardized program of education and exercise created to help patients with established heart disease and those who have been hospitalized for heart failure or heart attack.
According to research, the risk of death from heart diseases is reduced considerably by cardiac rehab programs. It also reduces the need for frequent hospital visits and the risk of future issues in the heart. But many people have low access to rehab services because of costs, transport issues, and availability of rehab programs.
Added to this, the public health emergency caused by the Covid-19 pandemic has resulted in many challenges in offering outpatient, on-site cardiopulmonary rehab in community sites and hospitals. In some countries, non-essential services were suspended because of the need for social distancing. This prevented group activities like on-site, in-person cardiac rehab programs. As such, health care centers have adapted to the needs of the pandemic by offering remote delivery, also referred to as telehealth rehab services.
Results of studies have shown that remote cardiac rehab programs are just as effective as an outpatient, in-center rehab programs. In fact, quality of life scores was superior in those who received remote rehab care.
Studies also showed that the rate of participation in remote cardiac rehab programs was much higher during the pandemic. Before Covid-19, only 3% of patients gained remote rehab, but during the period of the pandemic, 69% of patients took part in remote cardiac rehab programs.
Remote COPD Rehab
Reasons for poor use of pulmonary rehab included barriers such as limited capacity, low number of programs, low insurance cover, co-morbidity issues, and general lack of awareness. Such issues can be solved by remote pulmonary rehab programs.
Tele-rehab or home-based pulmonary rehab implies delivering rehab services via computer or phone-based applications. This has proved useful for patients who cannot travel to medical centers for rehab programs, as in the case of the global pandemic.
There have been many studies on the efficacy of remote rehab for cardiopulmonary issues. Most of the research has indicated a substantial improvement in quality of life, dyspnea, and exercise capacity through telemedicine in delivering pulmonary rehab programs.
The benefits of home pulmonary rehabilitation programs for COPD were recorded irrespective of age, socioeconomic status, or gender. The risk of adverse events in the future has also been found to be lesser than in the case of center-based rehab.
In sum, cardiopulmonary rehab through online or telemedicine modalities appears to be safe and effective. It has risen relevance during the pandemic era, and economic studies even indicate enhanced utility at lower costs. Outcomes of treatment depend on shared decision-making between medical service providers and patients. Patient safety is also a significant issue.