{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T02:57:17Z","timestamp":1787626637961,"version":"build-2736575974"},"reference-count":37,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,11]],"date-time":"2024-06-11T00:00:00Z","timestamp":1718064000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Chronic Obstructive Pulmonary Disease (COPD) is the third most common cause of death globally. Pulmonary rehabilitation (PR) programmes are important to reduce COPD symptoms and improve the quality of life of people with COPD. Digital health interventions have recently been adopted in PR programmes, which allow people with COPD to participate in such programmes with low barriers. The aim of this study is to review and discuss the reported effects of digital health interventions on PR outcomes in people with COPD. Materials and Methods: To achieve the study goals, a systematic literature search was conducted using PubMed (MEDLINE), CINAHL, AMED, SPORTDiscus and the Physiotherapy Evidence Database. Randomised clinical trials (RCTs) were included if they met specified criteria. Two reviewers independently checked titles, abstracts, and performed full-text screening and data extraction. The quality assessment and risk of bias were performed in accordance with the PEDRO scale and Cochrane Risk of Bias tool 2, respectively. Results: Thirteen RCTs were included in this systematic review with 1525 participants with COPD. This systematic review showed the potential positive effect of digital health PR on the exercise capacity\u2014measured by 6- and 12-min walking tests, pulmonary function, dyspnoea and health-related quality of life. There was no evidence for advantages of digital health PR in the improvement of anxiety, depression, and self-efficacy. Conclusions: Digital health PR is more effective than traditional PR in improving the pulmonary and physical outcomes for people with COPD, but there was no difference between the two PR programmes in improving the psychosocial outcomes. The certainty of the findings of this review is affected by the small number of included studies.<\/jats:p>","DOI":"10.3390\/medicina60060963","type":"journal-article","created":{"date-parts":[[2024,6,12]],"date-time":"2024-06-12T06:47:30Z","timestamp":1718174850000},"page":"963","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The Effects of Digital Health Interventions for Pulmonary Rehabilitation in People with COPD: A Systematic Review of Randomized Controlled Trials"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2185-0859","authenticated-orcid":false,"given":"Aseel","family":"Aburub","sequence":"first","affiliation":[{"name":"Department of Physiotherapy, Applied Science Private University, Amman 11931, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0535-0195","authenticated-orcid":false,"given":"Mohammad Z.","family":"Darabseh","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, School of Rehabilitation Sciences, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahaf","family":"Badran","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy, Faculty of Applied Medical Sciences, Middle East University, Amman 11831, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owis","family":"Eilayyan","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Al-Ahliyya Amman University, Amman 19111, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ala\u2019a M.","family":"Shurrab","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Science, Faculty of Medicine, Al-Balqa Applied University, Al Salt 19117, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7399-4841","authenticated-orcid":false,"given":"Hans","family":"Degens","sequence":"additional","affiliation":[{"name":"Department of Life Sciences, Institute of Sport, Manchester Metropolitan University, Manchester M1 5GD, UK"},{"name":"Institute of Sport Science and Innovations, Lithuanian Sports University, LT-44221 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.1164\/rccm.201309-1634ST","article-title":"An official American Thoracic Society\/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation","volume":"188","author":"Spruit","year":"2013","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"733","DOI":"10.1016\/S0140-6736(09)61303-9","article-title":"Chronic obstructive pulmonary disease in non-smokers","volume":"374","author":"Salvi","year":"2009","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1016\/S0140-6736(20)30925-9","article-title":"Global burden of 369 diseases and injuries in 204 countries and territories, 1990\u20132019: A systematic analysis for the Global Burden of Disease Study 2019","volume":"396","author":"Vos","year":"2020","journal-title":"Lancet"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.2147\/COPD.S188141","article-title":"Activity-related dyspnea in chronic obstructive pulmonary disease: Physical and psychological consequences, unmet needs, and future directions","volume":"14","author":"Hanania","year":"2019","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.rmed.2016.11.005","article-title":"The effects of chronic obstructive pulmonary disease self-management interventions on improvement of quality of life in COPD patients: A meta-analysis","volume":"121","author":"Cannon","year":"2016","journal-title":"Respir. Med."},{"key":"ref_6","first-page":"1606","article-title":"Pulmonary rehabilitation for COPD: Are programs with minimal exercise equipment effective?","volume":"6","author":"Alison","year":"2014","journal-title":"J. Thorac. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"780736","DOI":"10.3389\/fresc.2022.780736","article-title":"Embedding Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease in the Home and Community Setting: A Rapid Review","volume":"3","author":"Pereira","year":"2022","journal-title":"Front. Rehabil. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1513\/AnnalsATS.201910-800OC","article-title":"Experiences of Pulmonary Rehabilitation in People Living with Chronic Obstructive Pulmonary Disease and Frailty. A Qualitative Interview Study","volume":"17","author":"Brighton","year":"2020","journal-title":"Ann. Am. Thorac. Soc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.hrtlng.2024.05.001","article-title":"Routine in-hospital interventions during acute exacerbation of COPD are associated with improved 30-day care","volume":"67","author":"Freund","year":"2024","journal-title":"Heart Lung"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2696","DOI":"10.1016\/j.jacc.2017.10.018","article-title":"2017 Roadmap for Innovation-ACC Health Policy Statement on Healthcare Transformation in the Era of Digital Health, Big Data, and Precision Health: A Report of the American College of Cardiology Task Force on Health Policy Statements and Systems of Care","volume":"70","author":"Bhavnani","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2680","DOI":"10.1016\/j.jacc.2018.03.523","article-title":"Using Digital Health Technology to Better Generate Evidence and Deliver Evidence-Based Care","volume":"71","author":"Sharma","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1016\/j.jclinepi.2009.10.005","article-title":"There was evidence of convergent and construct validity of Physiotherapy Evidence Database quality scale for physiotherapy trials","volume":"63","author":"Macedo","year":"2010","journal-title":"J. Clin. Epidemiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.jclinepi.2017.03.002","article-title":"The PEDro scale had acceptably high convergent validity, construct validity, and interrater reliability in evaluating methodological quality of pharmaceutical trials","volume":"86","author":"Yamato","year":"2017","journal-title":"J. Clin. Epidemiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.2522\/ptj.20110274","article-title":"Extended exercise rehabilitation after hip fracture improves patients\u2019 physical function: A systematic review and meta-analysis","volume":"92","author":"Auais","year":"2012","journal-title":"Phys. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.2196\/jmir.990","article-title":"Randomized controlled trial of an internet-based versus face-to-face dyspnea self-management program for patients with chronic obstructive pulmonary disease: Pilot study","volume":"10","author":"Nguyen","year":"2008","journal-title":"J. Med. Internet Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e264","DOI":"10.2196\/jmir.6743","article-title":"Evaluating a Web-Based Coaching Program Using Electronic Health Records for Patients With Chronic Obstructive Pulmonary Disease in China: Randomized Controlled Trial","volume":"19","author":"Lan","year":"2017","journal-title":"J. Med. Internet Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1155\/2011\/640865","article-title":"Using Telehealth technology to deliver pulmonary rehabilitation in chronic obstructive pulmonary disease patients","volume":"18","author":"Stickland","year":"2011","journal-title":"Can. Respir. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1111\/resp.12966","article-title":"Home-based telerehabilitation via real-time videoconferencing improves endurance exercise capacity in patients with COPD: The randomized controlled TeleR Study","volume":"22","author":"Tsai","year":"2017","journal-title":"Respirology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1602129","DOI":"10.1183\/13993003.02129-2016","article-title":"Home-based maintenance tele-rehabilitation reduces the risk for acute exacerbations of COPD, hospitalisations and emergency department visits","volume":"49","author":"Vasilopoulou","year":"2017","journal-title":"Eur. Respir. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1136\/thoraxjnl-2019-214246","article-title":"Supervised pulmonary tele-rehabilitation versus pulmonary rehabilitation in severe COPD: A randomised multicentre trial","volume":"75","author":"Hansen","year":"2020","journal-title":"Thorax"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1164\/rccm.202204-0643OC","article-title":"Long-term Telerehabilitation or Unsupervised Training at Home for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial","volume":"207","author":"Zanaboni","year":"2023","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"106129","DOI":"10.1016\/j.rmed.2020.106129","article-title":"12-months follow-up of pulmonary tele-rehabilitation versus standard pulmonary rehabilitation: A multicentre randomised clinical trial in patients with severe COPD","volume":"172","author":"Godtfredsen","year":"2020","journal-title":"Respir. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1177\/0269215513512495","article-title":"A telerehabilitation intervention for patients with Chronic Obstructive Pulmonary Disease: A randomized controlled pilot trial","volume":"28","author":"Tabak","year":"2014","journal-title":"Clin. Rehabil."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e014580","DOI":"10.1136\/bmjopen-2016-014580","article-title":"Online versus face-to-face pulmonary rehabilitation for patients with chronic obstructive pulmonary disease: Randomised controlled trial","volume":"7","author":"Bourne","year":"2017","journal-title":"BMJ Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.arbres.2020.03.034","article-title":"Telerehabilitation Programme as a Maintenance Strategy for COPD Patients: A 12-Month Randomized Clinical Trial","volume":"57","author":"Galdiz","year":"2021","journal-title":"Arch. Bronconeumol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1186\/s13063-023-07239-7","article-title":"Comparing the effects of smartphone-based and face-to-face pulmonary rehabilitation education on caregiver burden and quality of life among the family caregivers of patients with chronic obstructive pulmonary disease: A randomized controlled field trial","volume":"24","author":"Bahadori","year":"2023","journal-title":"Trials"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1136\/thoraxjnl-2021-218338","article-title":"Using a smartphone application maintains physical activity following pulmonary rehabilitation in patients with COPD: A randomised controlled trial","volume":"78","author":"Spielmanns","year":"2023","journal-title":"Thorax"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.pec.2007.10.004","article-title":"Meta-analysis of patient education interventions to increase physical activity among chronically ill adults","volume":"70","author":"Conn","year":"2008","journal-title":"Patient Educ. Couns."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"106947","DOI":"10.1016\/j.rmed.2022.106947","article-title":"Efficacy of self-management mobile applications for patients with breathlessness: Systematic review and quality assessment of publicly available applications","volume":"201","author":"Sunjaya","year":"2022","journal-title":"Respir. Med."},{"key":"ref_30","first-page":"Cd002990","article-title":"Self management for patients with chronic obstructive pulmonary disease","volume":"2014","author":"Zwerink","year":"2014","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e24602","DOI":"10.2196\/24602","article-title":"Blended Self-Management Interventions to Reduce Disease Burden in Patients With Chronic Obstructive Pulmonary Disease and Asthma: Systematic Review and Meta-analysis","volume":"23","author":"Song","year":"2021","journal-title":"J. Med. Internet Res."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Preedy, V.R., and Watson, R.R. (2010). Exercise and Quality of Life in COPD. Handbook of Disease Burdens and Quality of Life Measures, Springer.","DOI":"10.1007\/978-0-387-78665-0"},{"key":"ref_33","first-page":"682","article-title":"Effect of exercise on the quality of life and pulmonary function in patients with chronic obstructive pulmonary disease","volume":"36","author":"Chen","year":"2011","journal-title":"J. Cent. South Univ. Med. Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.2147\/COPD.S221673","article-title":"Comprehensive Effects of Organized Education for Patients with Chronic Obstructive Pulmonary Disease","volume":"14","author":"Jang","year":"2019","journal-title":"Int. J. Chronic Obstr. Pulm. Dis."},{"key":"ref_35","unstructured":"NHS England (2024, April 08). Pulmonary Rehabilitation. What Is Pulmonary Rehabilitation (PR)?. Available online: https:\/\/www.england.nhs.uk\/ourwork\/clinical-policy\/respiratory-disease\/pulmonary-rehabilitation\/#:~:text=PR%20focuses%20on%20tailored%20physical,including%20feeling%20short%20of%20breath."},{"key":"ref_36","unstructured":"Shenoy, M.A., and Paul, V. (2024, April 08). Pulmonary Rehabilitation. Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK563166\/."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1007\/s00508-021-01930-y","article-title":"Role of new digital technologies and telemedicine in pulmonary rehabilitation: Smart devices in the treatment of chronic respiratory diseases","volume":"133","author":"Fekete","year":"2021","journal-title":"Wien. Klin. Wochenschr."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/6\/963\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:56:50Z","timestamp":1760108210000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/6\/963"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,11]]},"references-count":37,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["medicina60060963"],"URL":"https:\/\/doi.org\/10.3390\/medicina60060963","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,11]]}}}