Evaluation Of The Effect Of Home-based Pulmonary Rehabilitation Under Remote Supervision And Guidance In Patients With Stable COPD

Objective:To explore the role of remote supervision and guidance in home-based pulmonary rehabilitation of patients with stable chronic obstructive pulmonary disease;To explore the pulmonary rehabilitation training program suitable for patients with stable chronic obstructive pulmonary disease and the feasibility and effectiveness of this training program.Methods:From November 2021 to May 2022,90 patients with chronic obstructive pulmonary disease who were in stable condition and met the criteria for inclusion after attending the First Hospital of Shanxi Medical University were selected,and were divided into drug group,control group and intervention group according to the random number table method,with 30 cases in each group.The drug group received only conventional drug treatment,the control group combined with home self-monitoring pulmonary rehabilitation training on the basis of conventional drug treatment,and the intervention group combined with pulmonary rehabilitation training under remote supervision and guidance on the basis of conventional drug treatment.The contents of pulmonary rehabilitation training in the control group and the intervention group were consistent,and both were a set of pulmonary rehabilitation programs formulated by our research group.After 12 weeks,compare the three groups of lung function indexes[including forced expiratory volume in one second（FEV₁）,percentage of predicted forced expiratory volume in one second（FEV₁%pred）,forced expiratory volume in one second/forced vital capacity（FEV₁/FVC）],6-minute walk distance（6MWD）,grip strength,physical function[including 4-meter gait speed,the five repetition sit-to-stand（5STS）,balance ability（standing with two feet together,semi-tandem standing,standing in tandem）],modified medical research council dyspnea score（m MRC）,COPD assessment test（CAT）and compare rehabilitation compliance between the intervention group and control group.Results:1.In the drug group,there were 30 cases without withdrawal.In the control group,3 cases withdrew due to shoulder joint pain and other personal reasons,and remaining 27cases.In the intervention group,1 case withdrew due to knee joint pain,and remaining29 cases.2.There was no significant difference in the general clinical data among the three groups（P>0.05）.3.Comparison of observation indexes before treatment among the three groups:Before treatment,there were no significant differences in lung function indexes（including FEV₁,FEV₁%pred,FEV₁/FVC）,6MWD,grip strength,4-meter gait speed,5STS,balance ability,m MRC and CAT among the three groups（P>0.05）.4.Comparison of observation indexes after treatment among the three groups:After treatment,the differences of 6MWD,grip strength,4-meter gait speed,5STS and CAT among the three groups were statistically significant（P<0.05）,and the differences between the intervention group and drug group,intervention group and control group were statistically significant（P<0.05）.There were no significant differences in lung function indexes（including FEV₁,FEV₁%pred,FEV₁/FVC）,balance ability and m MRC among the three groups（P>0.05）.5.Comparison of observation indexes before and after treatment in each group:After treatment,lung function indexes（including FEV₁,FEV₁%pred,FEV₁/FVC）,6MWD,grip strength,4-meter gait speed,5STS and CAT were improved in intervention group and control group compared with before treatment,and the difference was statistically significant（P<0.05）,while balance ability and m MRC were not significantly improved compared with before treatment（P>0.05）.CAT in drug group was improved compared with before treatment,and the difference was statistically significant（P<0.05）,while other indexes were not significantly improved（P>0.05）.6.Compared with the control group,the intervention group had better rehabilitation compliance,and the difference was statistically significant（P<0.05）.Conclusion:1.Compared with home self-monitoring,home-based pulmonary rehabilitation under remote supervision and guidance is more conducive to improving lung function,exercise endurance,physical function,quality of life and rehabilitation compliance of patients with stable chronic obstructive pulmonary disease.2.The pulmonary rehabilitation training program developed by this research group is safe,feasible and effective,and can be further popularized and used.