The Effectiveness Pulmonary Telerehabilitation and Cognitive Telerehabilitation in COPD Patients
Condition: Severe Chronic Obstructive Pulmonary Disease; Dyspnea; Muscle Weakness; Fatigue; Quality of Life; Muscle Strength; Motor Imagery; Functional Capacity; Muscle; Accessory; Respiratory Disease; Pulmonary Disease; COPD
MeSH terms: Muscle Weakness; Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive; Dyspnea; Respiratory Tract Diseases; Respiration Disorders; Paresis
Study type: Interventional

Summary: 
      The aim of our study is to compare the effectiveness of the supervized pulmonary
      telerehabilitation program and the cognitive telerehabilitation method, which includes
      pulmonary telerehabilitation methods, in patients with severe stage COPD who have difficulty
      exercising heavily. The effects of pulmonary and cognitive rehabilitation on dyspnea, muscle
      strength, functional capacity, quality of life, anxiety and depression levels in this patient
      group will be examined.

      The number of studies in the literature in which the pulmonary rehabilitation program was
      applied as telerehabilitation is insufficient. Considering that this patient group is not
      motivated and has difficulty in exercising, motor imagery and movement observation methods
      from cognitive rehabilitation methods may be alternative methods for these patients. Although
      these methods have been very popular in recent years in terms of researching and
      demonstrating their effectiveness in various patient groups in the literature, no study has
      been found in which the effects of these methods have been applied in pulmonary disease
      groups. This study aims to contribute to the serious gap in the literature on the application
      of pulmonary telerehabilitation and its effectiveness, and to be an original study by
      investigating the effectiveness of motor imagery and action observation, which are popular
      rehabilitation methods of recent years, in COPD patients in the pulmonary disease group for
      the first time.
    

Detailed description: 
      The demographic information of the participants who accepted to participate in the study by
      reading and signing the voluntary consent form will be questioned with the demographic data
      form to be created by the researchers. The patients' dyspnea status will be evaluated with
      the Modified Medical Research Council Dyspnea Scale, and their exercise capacity will be
      evaluated with the 6-minute walk test (6 MWT). Modified Borg Scale will be used to determine
      dyspnea and leg fatigue before and after 6MWT, and a digital sphygmomanometer will be used to
      measure blood pressure. Before, during and after the test, saturation and heart rate will be
      determined by finger pulse oximetry. Blood lactate levels will be determined with a portable
      lactate meter. An electronic hand dynamometer will be used to measure peripheral muscle
      strength. Activities of daily living will be assessed with the London Chest Activity of Daily
      Living Scale. Quality of life will be determined by The Saint George Respiratory
      Questionnaire, and anxiety and depression status will be determined by the Hospital Anxiety
      and Depression Scale. Muscle activities will be analyzed using a surface electromyographic
      (EMG) measuring device. The mental imagery abilities of the patients will be evaluated with
      the Kinesthetic and Visual Imagery Questionnaire-20 and the mental chronometry method.

      Evaluations will be made by the responsible physiotherapist at the hospital before the
      program, at the end of the 4th week and at the end of the 8th week of the program. The
      permissions for the use of the questionnaires to be used were obtained from the authors, who
      made the validity and reliability in Turkish, via e-mail. Ethical approval of the study was
      obtained from the Ethics Committee of Istanbul Yedikule Chest Diseases and Thoracic Surgery
      Training and Research Hospital.
    

Intervention name(s): Supervised Pulmonary Telerehabilitation; Cognitive Telerehabilitation
Intervention type(s): Other; Other
Intervention description(s): For pulmonary rehabilitation to be applied in the simultaneous telerehabilitation method, digital blood pressure measurement device, digital finger pulse oximeter device will be given to severe COPD patients for safe exercise and they will be informed about confidence intervals and how to use saturation and heart rate monitors. The relevant program and points to be considered will be delivered to the patients in the form of an online PDF brochure.; These patients will be asked to do a standardized pulmonary telerehabilitation program three times a week for 8 weeks by watching videos consisting of commands and exercise videos transmitted to them, some of them by actively doing, imagining.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Randomized prospective clinical trial
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: severe COPD; Severe Chronic Obstructive Pulmonary Disease; Pulmonary Telerehabilitation; Cognitive Telerehabilitation; Motor Imagery; Action Observation; Dyspnea; Muscle Strength; Blood Lactate Level; Daily Living Activities; Quality of Life; Muscle Weakness; Functional Capacity