The following is a summary of “A remote monitoring-enabled home exercise prescription for patients with interstitial lung disease at risk for exercise-induced desaturation,” published in the NOVEMBER 2023 issue of Pulmonology by Child, et al.
There was a growing need for alternative approaches to center-based pulmonary rehabilitation to enhance patient access to this vital therapy. An essential challenge is ensuring unsupervised exercise safety, especially for at-risk patients. For a study, researchers sought to investigate the safety, feasibility, and effectiveness of a novel remote monitoring-enabled mobile health (mHealth) program for individuals who experience exercise-induced hemoglobin desaturation.
The study concentrated on individuals with lymphangioleiomyomatosis (LAM), a rare interstitial lung disease (ILD) commonly associated with substantial exercise-induced desaturation. Over a 12-week program, participants’ hemoglobin saturation (SpO2) was continuously monitored during all home exercise sessions. The intervention’s effects were assessed using various measurements, including the 6-minute walk test (6MWT), maximal cardiopulmonary exercise test (CPET), lower extremity computerized dynamometry, pulmonary function tests, and surveys on health-related quality of life (QoL). Safety was evaluated through blood biomarkers to gauge systemic inflammation and cardiac wall stress and monitor the incidence of adverse events.
About 15 LAM patients enrolled in the program, with 14 completing it, demonstrating high adherence to aerobic (87 ± 15%) and strength (87 ± 12%) training components. The study introduced an innovative method of characterizing exercise training SpO2, revealing that while mild-to-moderate desaturation was common during home workouts, participants were able to self-regulate exercise intensity and supplemental oxygen levels to maintain the recommended exercise parameters. Significant improvements were observed, including increased 6MWT distance (+36 ± 34 m, P = 0.003), CPET time (P = 0.04), muscular endurance (P = 0.008), QoL (P = 0.009 to 0.03), and reduced fatigue (P = 0.001 to 0.03). Patients expressed high acceptability and satisfaction with the program, blood biomarkers remained stable (P > 0.05), and no study-related adverse events were reported.
The study demonstrated that a remote monitoring-enabled home exercise program is a safe, practical, and effective approach, even for individuals who experience exercise-induced desaturation.
Source: resmedjournal.com/article/S0954-6111(23)00285-8/fulltext