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A Systematic Review to Explore How Exercise-based Physiotherapy via Telemedicine Can Promote Health Related Benefits for People With Cystic Fibrosis

Ben Bowhay, Jos M. Latour, Owen W. Tomlinson

Abstract: This systematic review evaluates the impact of physiotherapy exercises delivered via telemedicine on lung function and quality of life in individuals with Cystic Fibrosis (CF). Eight studies involving 180 participants met the inclusion criteria, employing various telemedicine-based interventions such as Tai-Chi, aerobic, and resistance exercises over a period of six to twelve weeks. While no significant changes in lung function were observed, improvements in the respiratory domain of the Cystic Fibrosis Questionnaire–Revised (CFQ-R) were noted. However, further research with standardized outcome measures, larger sample sizes, and longer follow-up periods is necessary before clinical practice recommendations can be established.

Introduction: Cystic Fibrosis (CF) is a multisystem disease primarily affecting the respiratory system, leading to chronic airway infection and respiratory disease. This review aims to investigate the effectiveness of telemedicine exercise interventions on lung function and quality of life in individuals with CF.

Materials and Methods: The systematic review followed the PRISMA 2020 Statement guidelines. Databases such as AMED, CINAHL, and MEDLINE were searched, and reference lists of included studies were hand-searched. Eight studies meeting the inclusion criteria were included, comprising various study designs and telemedicine-based interventions.

Results: Studies measuring percentage predicted forced expiratory volume in one second (ppFEV1) found no significant difference. However, improvements in the CFQ-R respiratory domain were observed in five studies, while two studies showed improvements in the CFQ-R physical domain. No adverse events were reported across all studies.

Discussion: The review suggests that telemedicine-based exercise interventions may have a beneficial impact on perceived quality of life for individuals with CF, despite no significant changes in lung function measurements. However, the methodological shortcomings and poor data quality of the included studies necessitate caution when evaluating the evidence.

Conclusion: Although telemedicine-based exercise shows promise in enhancing the quality of life of individuals with CF, further high-quality research is required to establish its impact on lung function outcomes. Larger randomized controlled trials with standardized interventions and longer follow-up periods are needed to inform evidence-based guidelines and clinical practice in this emerging field.

Acknowledgments: The authors acknowledge the contribution of Andrew Sawyer, Research Advisor at Birmingham City University, for assisting in the development of the search strategy.

Citation: Bowhay B, Latour JM, Tomlinson OW (2023) Effects of Telemedicine-Based Physiotherapy Exercises on Lung Function and Quality of Life in Cystic Fibrosis: A Systematic Review. PLOS Digital Health 2(2): e0000201. https://doi.org/10.1371/journal.pdig.0000201

Funding: The authors received no specific funding for this work.

Competing interests: The authors declare no competing interests.

Data Availability: All relevant data are presented in the manuscript and associated files.

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