J. King1, J. Harris2, M. McGrath1, V. Pelletier-Millette1, A. Privé1, C. Dolgowicz3, H. Soudant4, V. Filteau3, E. Holmes3
1University of Ottawa, Physiotherapy Program, School of Rehabilitation Sciences, Faculty of Health Sciences, Ottawa, Canada, 2University of Ottawa Heart Institute, Division of Cardiac Prevention and Rehabilitation, Ottawa, Canada, 3Lanark Renfrew Health & Community Services, Lanark, Canada, 4Ottawa Valley Family Health Team, Almonte, Canada

Background: Although it is well established that cardiac rehabilitation (CR) and pulmonary (PR) programs are effective, unfortunately throughout the world there is limited access to these services. Where there are programs, distance to travel and access to transportation have often been cited as barriers to participation. The structure of CR and PR have common components including exercise and patient education.
A unique combined CR and PR rural program was created by adapting an existing telerehabilitation CR program. The telerehabilitation program uses technology to video-link the small program with a larger urban program. The program triages participants to exercise classes based on their fitness levels, not on their diagnosis. All participants, regardless of diagnosis, attend education classes and receive individually tailored patient education and self-management strategies.

Purpose: To evaluate a combined cardiac and pulmonary telerehabilitation program in a rural setting and to describe the experiences of the participants involved in the program including to identify facilitators and barriers to participation.

Methods: Using a generalized qualitative approach, data was collected through semi-structured individual interviews with patient participants. Transcribed interviews were analyzed using constant comparison thematic analysis to systematically categorize and interpret data.

Results: Seven participants were interviewed, five women and two men. The participants' ages ranged from 63 to 82 years old. One participant had a pulmonary diagnosis and six with cardiac diagnoses. As well five participants were living with other co-morbidities. The interviews took place up to three months following the completion of the program. Themes identified were: Support of Family, Friends, Health Care Professionals and Other Participants, Location of the Program, Small Group Setting, Combining the Programs, and Positive Health Changes Due to Attending the Program. The participants identified facilitators of the program being the support from the community and health care professionals and the location of the program. As well regardless of diagnosis participants enjoyed exercising together and felt they were receiving the appropriate attention and the program was targeting their specific issues. All participants also noted that their commitment to attending the program was influenced greatly by the program’s location in their community. The only barriers identified to participation were due to severe winter conditions and at times not being aware of some of the education sessions provided.

Conclusion(s): The present evaluation identified a rich variety of themes regarding the benefits of a combined CR/PR program in the community. The participant’s insight demonstrates the potential of this type of program. Identifying these facilitators and barriers brought helpful information regarding access to rehabilitation programs in a rural community. It is an important first step towards understanding how such programs have positively impacted participation and engagement to a combined rehabilitation program.

Implications: This innovative program delivery model could be used by physiotherapists to implement in their own communities, especially rural communities, to help address the accessibility gap of CR and PR programs for people living with pulmonary and cardiac conditions. The combination of smaller rural community programs using telerehabilitation could also be helpful to address challenges in program delivery due to the pandemic.

Funding, acknowledgements: none 

Keywords: Telerehabilitation, Cardiac Rehabilitation, Pulmonary Rehabilitation

Topic: Cardiorespiratory

Did this work require ethics approval? No
Institution: The Ottawa Hospital/University of Ottawa
Committee: Ottawa Health Science Network Research Ethics Board
Reason: The project falls within the context of a program evaluation and does not require ethical approval in Canada.

All authors, affiliations and abstracts have been published as submitted.

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