Remote exercise testing in pulmonary hypertension (PHRET)

Abstract Remote exercise tests for patients with pulmonary hypertension (PH) would improve the telemedicine strategies in this disease. The PHRET study assessed the validity and feasibility of four remote exercise tests performed by PH patients at home. Participants undergoing diagnostic assessment...

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Main Authors: Harrison Stubbs, Stephanie Lua, Jamie Ingram, Bhautesh D. Jani, Melanie Brewis, Colin Church, Martin Johnson
Format: Article
Language:English
Published: Wiley 2023-10-01
Series:Pulmonary Circulation
Subjects:
Online Access:https://doi.org/10.1002/pul2.12325
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author Harrison Stubbs
Stephanie Lua
Jamie Ingram
Bhautesh D. Jani
Melanie Brewis
Colin Church
Martin Johnson
author_facet Harrison Stubbs
Stephanie Lua
Jamie Ingram
Bhautesh D. Jani
Melanie Brewis
Colin Church
Martin Johnson
author_sort Harrison Stubbs
collection DOAJ
description Abstract Remote exercise tests for patients with pulmonary hypertension (PH) would improve the telemedicine strategies in this disease. The PHRET study assessed the validity and feasibility of four remote exercise tests performed by PH patients at home. Participants undergoing diagnostic assessment for PH were included. At baseline, patients completed a 6MWT followed by a range of study tests including a Timed Up and Go (TUG) test, a Sit‐to‐Stand (STS), a Step Test (ST), and a tele‐6MWT (T6MWT) performed outside using a GPS‐enabled smartphone. Patients performed these tests at home following discharge and at first follow‐up. Analysis focused on comparing the results of study tests to the standard 6MWT. The discontinuation rate was 15%. Ninety‐seven percent of patients were able to complete a TUG, 92% a STS, 73% a ST, and 49% a T6MWT. At baseline, correlation between the standard 6MWT and study tests, respectively, was T6MWT 0.93, ST 0.78, STS 0.71, and TUG −0.76 (p < 0.001). Direction of change in the study test agreed with the standard 6MWT in 68% of the follow‐up ST, 68% of the STS, 71% of the TUG, and 79% of the T6MWT. Patients were able to complete the tests at home, there were no adverse incidents and ≥92% of patients were happy to continue performing home tests. Remote exercise testing is feasible. The T6MWT was a valid remote measure of exercise capacity, but could only be performed by a limited number of patients. The high discontinuation rate may impact the utility of remote tests.
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spelling doaj.art-9e0e4b6cfec5495cadb3f5d99197e11a2023-12-28T19:02:35ZengWileyPulmonary Circulation2045-89402023-10-01134n/an/a10.1002/pul2.12325Remote exercise testing in pulmonary hypertension (PHRET)Harrison Stubbs0Stephanie Lua1Jamie Ingram2Bhautesh D. Jani3Melanie Brewis4Colin Church5Martin Johnson6Scottish Pulmonary Vascular Unit Golden Jubilee National Hospital Glasgow UKScottish Pulmonary Vascular Unit Golden Jubilee National Hospital Glasgow UKScottish Pulmonary Vascular Unit Golden Jubilee National Hospital Glasgow UKGeneral Practice and Primary Care, School of Health & Wellbeing University of Glasgow Glasgow UKScottish Pulmonary Vascular Unit Golden Jubilee National Hospital Glasgow UKScottish Pulmonary Vascular Unit Golden Jubilee National Hospital Glasgow UKScottish Pulmonary Vascular Unit Golden Jubilee National Hospital Glasgow UKAbstract Remote exercise tests for patients with pulmonary hypertension (PH) would improve the telemedicine strategies in this disease. The PHRET study assessed the validity and feasibility of four remote exercise tests performed by PH patients at home. Participants undergoing diagnostic assessment for PH were included. At baseline, patients completed a 6MWT followed by a range of study tests including a Timed Up and Go (TUG) test, a Sit‐to‐Stand (STS), a Step Test (ST), and a tele‐6MWT (T6MWT) performed outside using a GPS‐enabled smartphone. Patients performed these tests at home following discharge and at first follow‐up. Analysis focused on comparing the results of study tests to the standard 6MWT. The discontinuation rate was 15%. Ninety‐seven percent of patients were able to complete a TUG, 92% a STS, 73% a ST, and 49% a T6MWT. At baseline, correlation between the standard 6MWT and study tests, respectively, was T6MWT 0.93, ST 0.78, STS 0.71, and TUG −0.76 (p < 0.001). Direction of change in the study test agreed with the standard 6MWT in 68% of the follow‐up ST, 68% of the STS, 71% of the TUG, and 79% of the T6MWT. Patients were able to complete the tests at home, there were no adverse incidents and ≥92% of patients were happy to continue performing home tests. Remote exercise testing is feasible. The T6MWT was a valid remote measure of exercise capacity, but could only be performed by a limited number of patients. The high discontinuation rate may impact the utility of remote tests.https://doi.org/10.1002/pul2.123256‐min walk testrisk assessmentrisk stratificationtelehealthtelemedicine
spellingShingle Harrison Stubbs
Stephanie Lua
Jamie Ingram
Bhautesh D. Jani
Melanie Brewis
Colin Church
Martin Johnson
Remote exercise testing in pulmonary hypertension (PHRET)
Pulmonary Circulation
6‐min walk test
risk assessment
risk stratification
telehealth
telemedicine
title Remote exercise testing in pulmonary hypertension (PHRET)
title_full Remote exercise testing in pulmonary hypertension (PHRET)
title_fullStr Remote exercise testing in pulmonary hypertension (PHRET)
title_full_unstemmed Remote exercise testing in pulmonary hypertension (PHRET)
title_short Remote exercise testing in pulmonary hypertension (PHRET)
title_sort remote exercise testing in pulmonary hypertension phret
topic 6‐min walk test
risk assessment
risk stratification
telehealth
telemedicine
url https://doi.org/10.1002/pul2.12325
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