Please select the eligibility criteria that correspond to the clinical trial below.
Title: Feasibility & Effect of a Tele-rehabilitation Program for Chronic Obstructive Pulmonary Disease vs. Standard Rehabilitation
Brief Summary: Introduction In order to guarantee chronic patients and elderly a high quality service from health care organizations in the coming decades, new technologies have been implemented to treat patients from a distance. There is still a need for more studies on the efficacy and cost-effectiveness of tele-rehabilitation (TR) and its long-term effects needs also to be determined. To guarantee individuals with chronic obstructive pulmonary diseases (COPD) a high quality service from health care organizations in the coming decades and economically save the national health systems for an expensive bill for the treatment of COPD, new actions plans has to be taken into use. Hereby, more patients can be treated with less human resources while still sustaining or even improving today's services. The importance of such welfare action plans has to maintain a high quality of service that individuals with COPD are willing to accept. Here, TR seems to be a good welfare action plans. Despite proof of improved cost-effectiveness, no studies support the benefits of TR in COPD patient with respect to adherence, security, treatment efficacy and improved quality of life.

Aim To assess and compare the feasibility and effect of a tele-rehabilitation program with a new and innovative TR platform (NITRP) compared to standard treatment with respect to exercise capacity, quality of life and activities of daily living in patients with COPD.

Method and material The study is a prospective randomized controlled trial comparing the effects of tele-rehabilitation and conventional rehabilitation in patients with severe COPD. 54 patients fulfilling the inclusion criteria will be randomized in two groups to either a 8 week tele-rehabilitation program or a conventional COPD rehabilitation program at the hospital. Participants will be tested at baseline, 8 weeks, 3 and 6 months after cessation of the training programs. In the intervention group, a real- and a virtual physiotherapist agent will facilitate the rehabilitation.

Ethical considerations This study will not pose any risk to the patient as compared to current practice. Participation is voluntary and the patient may at any time withdraw from the study without consequences for future care or treatment. The questionnaires and the test methods used are clinically recognized instruments. Signed informed consent will be obtained from the all participants after verbal and written information and before the study starts. The study will not be initiated before approval from the Ethics Committee and the Data Protection Agency has been obtained. The study will follow the general research ethical rules as expressed in the Helsinki Declaration II.


Options:
A: Inclusion Criteria:

* A physician diagnosis of COPD
* Age 45 years and older
* Affirmative response to "Are you short of breath when hurrying on the level or walking up a slight hill?"
* Post-bronchodilator FEV1/FVC \<0.7 and FEV1 \<70%

Exclusion Criteria:

* Inability to speak/read English
* Lives in a chronic care facility (i.e., nursing home, assisted living)
* Plans to move from the area within the next 18 months
* Life expectancy less than 12 months
* Participation in pulmonary rehabilitation or other clinical research in the past 12 months
* Inability to walk without assistance of a wheelchair or walker
* Inability to walk at least 110m on a 6-minute walk
* Uncontrolled angina, hypertension, psychiatric illness, or dementia
* Inability to obtain supplemental oxygen if indicated
B: Inclusion Criteria:

* A diagnosis of COPD (FEV1/FVC \< 70% in a stable phase of the disease)
* Age \> 18 years
* Referred for conventional COPD rehabilitation
* Compliant patient willing to fulfill the study requirements
* Signed informed consent (Oxygen therapy is not an obstacle for participation).

Exclusion Criteria:

* Musculoskeletal disorders limiting training
* Dizziness, significant sensory or motor disabilities, dementia or terminal malignant disease precluding training
* Severe comorbidities such as i.e. unstable heart disease, dysregulated diabetes, known malignant disease, any other illness making the patient inappropriate for participating in the study
* Non-compliant patient
* Severe vision or hearing impairment
* Non-Danish speaking
* Unwillingness or inability to follow the protocol
* COPD exacerbation in the preceding 6 weeks
C: Inclusion Criteria:

* Admissions for chronic obstructive pulmonary disease
* Age 20 or more

Exclusion Criteria:

* Discharge against medical advice
* Enrolled in other trials
* Not being discharged to home
* Unconsciousness
D: Inclusion Criteria:

* Moderate to severe COPD according to the recent GOLD guidelines
* Reduced exercise capacity during an incremental exercise test of less than 70% of predicted normal values

Exclusion Criteria:

* Lack of motivation to participate in the treatment program
* Other pathologic conditions unabling participation in the training program (e.g. coronary, orthopaedic, neurological or severe endocrine disorders)
* participation in other pulmonary rehabilitation projects

Answer: B