Feasibility study of home-based pulmonary rehabilitation (PR) in Bangladesh

Aim: PR is an integral part of chronic respiratory disease (CRD) management. Evidence on the effectiveness, applicable components, and deliverable models have generated from high-income countries a different clinical context from low- and middle-income countries. Informed by global PR guidelines, a systematic review and stakeholder engagement, we adapted a PR programme to home-based (because of COVID) in a low-resource setting. This feasibility study tested the PR programme in Bangladesh. Methods: Intervention was, assessment at the PR centre, twice-weekly tele-supervised sessions for 8 weeks at home. Primary outcomes were Endurance Shuttle Walk Test (ESWT) and COPD Assessment Test (CAT). Nonparametric tests were used to compare pre-and post- outcomes using SPSS version 26. Results: 51 participants (33 male; mean age 55yrs (SD 12)) were recruited with a range of CRDs. 40 completed the final assessment (COVID deterred eight follow-ups). Both ESWT and CAT improved by more than the minimum clinically important difference (MCID). Individual changes in ESWT and CAT are illustrated in the figure Conclusion: Home-based PR is feasible in the Bangladesh context and associated with significant improvements in functional exercise capacity and health-related quality of life.