Fit 4 surgery, a bespoke app with biofeedback delivers rehabilitation at home before and after elective lung resection
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(2019) 14:132
RESEARCH ARTICLE
Open Access
Fit 4 surgery, a bespoke app with biofeedback delivers rehabilitation at home before and after elective lung resection Salma Bibi Kadiri1, Amy Pamela Kerr1, Nicola Katy Oswald2, Alina-Maria Budacan1, Sarah Flanagan3, Christopher Golby4, Stuart Lightfoot1 and Babu Naidu1,2*
Abstract Background: Pulmonary rehabilitation programme for lung surgery patients can reduce the risk of post-operative complications but compliance to programmes can be limited by access to health care. We developed a homebased rehabilitation app and tested its feasibility in patients undergoing lung resection surgery. Methods: A cohort study was conducted over 18 months at a regional thoracic unit. The Fit 4 Surgery app included ten exercises. Patients were instructed to exercise for at least three minutes for each exercise. Data was transmitted back to the researchers remotely. Data was also collected from a contemporaneous group of surgery patients who attended local outpatient-based Chronic Obstructive Pulmonary Disease rehabilitation classes. Quality of Life and outcomes data in the app group were collected. Patients were also interviewed about their experience of the app. Results: App patients had a shorter wait before surgery compared to patients attending rehabilitation classes (24 vs 45 days) but managed four times as many sessions (2 vs 9), improving incremental shuttle walk test distance by 99 ± 83 (p < 0.05) metres before surgery. Five themes were gathered from the interviews. Conclusion: An app based programme of rehabilitation can be delivered in a timely fashion to lung surgery patients with demonstrable physiological benefits; this will need to be confirmed in further clinical trials. Clinical trial registration number: ISRCTN00061628. Registered 27 May 2011. Keywords: Pulmonary rehabilitation, Lung Cancer, Exercise, Thoracic surgery, Quality of life, Intervention, Technology
Background Up to 15% of patients develop post- operative complications after lung surgery which can result in death, admission into an intensive care unit, prolonged hospital stay and readmission to hospital after discharge [1, 2]. The evidence on pre- and post-operative rehabilitation in lung resection surgery is poor, mainly due to the heterogeneity of patient population, interventions and outcomes * Correspondence: [email protected] 1 Department of Thoracic Surgery Research, Heartlands Hospital, Bordesley Green East, Birmingham B9 5SS, UK 2 Institute of Inflammation and Ageing, College of Medical and Dental Sciences, Centre for Translational Inflammation Research, University of Birmingham Laboratories, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham B15 2TT, UK Full list of author information is available at the end of the article
[3]. Recently published Enhanced Recovery After Surgery guidelines recommend the use of prehabilitation for patients with borderline lung function or exercise capacity [4]. Meta-analysis of studies of pulmonary rehabilitation and/or exercise classes for lung surgery pa
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