Reduction in 6-minute walk distance during COVID-19 restrictions in people undergoing pulmonary rehabilitation in Western Australia

Mrs Caitlin Vicary1, Mrs Peta Winship1, Ms Natasha Steere1, Mrs Dianne Lunt1, Dr Michael Musk2, Dr Kylie Hill3,4, Dr Vinicius Cavalheri3,4,5

1Physiotherapy Department, Fiona Stanley Hospital, Perth, Australia, 2Respiratory Medicine Department, Fiona Stanley Hospital , Perth , Australia, 3Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Australia, 4Institute for Respiratory Health, Perth, Australia, 5Allied Health, South Metropolitan Health Service, Perth, Australia

Introduction
During the COVID-19 restrictions in Western Australia (WA), face-to-face pulmonary rehabilitation programs (PRP) were delivered as home-based programs with telephone support. In those enrolled in a PRP at Fiona Stanley Hospital (FSH), this study reports the change in 6-minute walk distance (6MWD) measured before and after the period of restriction.

Methods
This is a retrospective analysis of data on 6MWD. Data were extracted on 6MWD measured at three time points; T0 – defined as the most recent 6MWD prior to transitioning to a home-based PRP (March 2020); T1 – defined as the first 6MWD on transitioning back to a face-to-face PRP (May 2020 onwards); and T2 – 6MWD following completion of at least eight weeks of face-to-face PRP.

Results
The time between T0 and T1 was 21±8 weeks and between T1 and T2 was 12±4 weeks. At T0 and T1, the 6MWD was available in 42 patients (age 62±11 yr, 23 [55%] COPD). Between these time points, 36 (90%) patients demonstrated a reduction in 6MWD, equivalent to -52m [95% CI -70 to -34]. At T3, 6MWD was available in 28 patients (age 61±10 yr, 13 (46%) COPD). Between T1 and T2, 23 (82%) patients demonstrated an increase in 6MWD, equivalent to 30m [95% CI 7 to 55].

Conclusion
A clinically important reduction in 6MWD was observed with the home-based program during the COVID-19 restrictions. Return to face-to-face PRP appears to ameliorate this deterioration. These results call into question the fidelity of home-based PRP supported only with telephone contact.


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