Impact of Telerehabilitation Training on Pediatric Cystic Fibrosis Patients: An Exploratory Study

Fitness in patients with Cystic fibrosis (CF) is an important biomarker associated with
higher survivability and improved quality of life. CF patients are encouraged to maintain an
active lifestyle, however, while physicians are able to prescribe airway clearance measures
or specific medications, there is no prescription for exercise or avenue to promote exercise
outside the clinic or hospital.

The advent of ubiquitous computing has transformed the landscape of healthcare delivery.
Thus far, exercise training in CF have either required patients travel to a gym or relied on
home visits or telephone calls. Virtual visits provide a novel and innovative platform to
deliver a live stream of exercise sessions with two-way video and audio capabilities,
allowing individualized attention to exercise for CF patient from the comfort and privacy of
their homes. Applications of tele-exercise, or tele-rehabilitation, have been shown to be as
effective as in conventional physical therapy following orthopedic surgeries and, in stroke
patients, to optimize patient outcome by prolonging duration of treatment and preventing the
observed decline after the termination of therapy. For CF patients, the latter is especially
important given the impact of hospitalizations for acute exacerbations on exercise
tolerance. In this particular population, where cross-contamination risks limit use of group
exercise activity, using two-way video telecommunication allows participation in exercise
programs while adhering to the standards of CF management regarding infection control.

This study would be the first to evaluate implementing tele-exercise and remote monitoring
program on pediatric CF patients. Our pediatric CF patients will be enrolled in a six-week
exercise program that is streamed live from an instructor into their computers at home via a
HIPAA compliant telemedicine platform. Remote monitoring devices, such as accelerometers and
wireless heart rate monitors, will evaluate baseline habitual activity and intensity of
exercise, respectively. The goal of this study is to show that tele-exercise program is a
feasible and convenient and cost-effective method to enhance CF care for our patients.