A randomised controlled study of the efficacy of Internet of Things-based telerespiratory rehabilitation for chronic respiratory diseases

OBJECTIVE: To explore IoT-based remote respiratory rehabilitation for chronic respiratory disease patients at home. DESIGN: This was a randomised controlled trial. SETTING: The study took place in patients' homes (post-discharge) and the Department of Respiratory and Critical Care Medicine of Binzhou People's Hospital, Shandong First Medical University (inpatient period). PARTICIPANTS: 123 patients (mean age 68.85 ± 10.72 years, 55% male) with chronic respiratory diseases. INTERVENTIONS: Patients were randomly assigned to either a 6-month Internet of Things (IoT)-based remote respiratory rehabilitation programme after hospital discharge (study group, n = 60) or usual care with conventional respiratory rehabilitation (control group, n = 63). MAIN OUTCOME MEASURES: The primary outcomes were the 6-min walking test (6MWT) and lung function (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1] and peak expiratory flow [PEF]). The secondary outcomes included the modified Medical Research Council (mMRC) dyspnoea index, diaphragm thickness and rehospitalisation rate. Outcomes were assessed at baseline (during hospitalisation, approximately 4 weeks before the intervention started) and after 6 months. RESULTS: The study group showed significantly greater improvements in 6MWT (mean difference 63.74 m, 95% CI 45.21-82.27), FVC (0.54 L, 95% CI 0.43-0.65), FEV1 (0.68 L, 95% CI 0.54-0.82), PEF (73.16 L/min, 95% CI 46.22-100) and diaphragm thickness (6.79 mm, 95% CI 4.68-8.90) than the control group (all p < 0.001). The between-group difference in 6MWT (63.74 m) exceeded the minimal clinically important difference (30 m) for chronic respiratory diseases. CONCLUSION: A 6-month IoT-based remote respiratory rehabilitation programme significantly improved exercise capacity, lung function, dyspnoea index and respiratory muscle strength and reduced rehospitalisations when compared with conventional rehabilitation in patients with chronic respiratory diseases.