Retrospective Evaluation of the Implementation of a Digital Solution Supporting the Delivery of Pulmonary Rehabilitation Programs in Private Physiotherapy Practice (DIGILIB-RR)

Pulmonary rehabilitation improves exercise capacity, functional status, symptoms and quality of life in individuals with chronic respiratory diseases. However, access to pulmonary rehabilitation remains limited due to insufficient availability of specialized centers and geographical, organizational, logistical, and financial barriers. Delivering pulmonary rehabilitation in private physiotherapy practices may improve access to care, but implementation can be challenged by limited resources, equipment, and support tools.

A field-based implementation program was conducted from summer 2025 to support physiotherapists in delivering pulmonary rehabilitation in private practice through the provision of a digital support solution (TELEREHAPP) and, where appropriate, associated equipment. During this program, physiotherapists collected data on solution use, patient characteristics, and available clinical follow-up indicators. Satisfaction and perceived usability were assessed among both physiotherapists and patients.

This retrospective study aims to analyze the data already collected during the implementation program to evaluate the feasibility of implementation, use, and acceptability of the TELEREHAPP digital solution in private physiotherapy practice, and to describe changes in available clinical outcomes among participating patients.

Study Overview

• Status: Active, not recruiting
• Conditions: Respiration Disorders; Pulmonary Rehabilitation; Chronic Obstructive Pulmonary Disease (COPD); Chronic Respiratory Diseases
• Intervention / Treatment: Device: TELEREHAPP-supported pulmonary rehabilitation

• Study Type: Observational
• Enrollment (Estimated): 50

Contacts and Locations

Study Locations

• France
  • Rouen, France, 76000
    • ADIR Association

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Adult patients with chronic respiratory diseases.

Description

Inclusion Criteria:

• Age superior to 18 years;
• Referred for pulmonary rehabilitation in private physiotherapy practice.

Non-inclusion Criteria:

- Not applicable

Exclusion Criteria:

- Not applicable

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

Participants; Physiotherapists and patients with chronic respiratory diseases participating in a pulmonary rehabilitation program in a private physiotherapy practice using a digital solution (TELEREHAPP).

Device: TELEREHAPP-supported pulmonary rehabilitation; Pulmonary rehabilitation supported by TELEREHAPP consisted of a program delivered in private physiotherapy practice using a digital health application designed to support the implementation, monitoring, and follow-up of rehabilitation and physical activity programs. Depending on the physiotherapist's usual practice and the patient's needs, the program could include endurance exercise training, muscle strengthening, physical activity coaching, self-administered questionnaires, and individualized monitoring by the physiotherapist. The digital solution was used as a support tool for care delivery and follow-up; the content, duration, frequency, and modalities of the program were determined by the treating physiotherapist.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physiotherapist Adoption of the Digital Solution	Proportion of equipped physiotherapists who used the solution to support at least one patient during the experimentation period.	6 to 10 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Physiotherapist Acceptance Rate	Proportion of contacted physiotherapists who agreed to be equipped with the digital solution.	Baseline
Number of Patients Managed	Total number of patients managed, number per physiotherapist, and number per physiotherapist per month.	6 to 10 months
Modules Used	Types of modules used within the digital solution (endurance training, muscle strengthening, physical activity coaching, self-administered questionnaires).	6 to 10 months
Number of Sessions Completed	Number of sessions completed for each module.	6 to 10 months
Program Duration	Duration of the proposed programs.	6 to 10 months
Program Frequency	Frequency of the proposed programs.	6 to 10 months
Physiotherapist Satisfaction	Satisfaction of physiotherapists with the care pathway involving the digital solution, assessed using an adapted Client Satisfaction Questionnaire-8 items. Scores therefore range from 8 to 32, with higher values indicating higher satisfaction.	6 to 10 months
Patient Satisfaction	Satisfaction of patients with the care pathway involving the digital solution, assessed using the Client Satisfaction Questionnaire-8 items. Scores therefore range from 8 to 32, with higher values indicating higher satisfaction.	6 to 10 months
Perceived Usability - Physiotherapists	Perceived usability of the digital solution by physiotherapists, assessed using the System Usability Scale. Scores therefore range from 0 to 100, with higher values indicating higher satisfaction.	6 to 10 months
Perceived Usability - Patients	Perceived usability of the digital solution by patients, assessed using the System Usability Scale. Scores therefore range from 0 to 100, with higher values indicating higher satisfaction.	6 to 10 months
Exercise Capacity - 6-Minute Walk Distance	Exercise capacity will be assessed using the 6-Minute Walk Test (6MWT) before and after the rehabilitation program. The test measures the distance walked in 6 minutes, expressed in meters, with higher values indicating greater exercise capacity.	8 to 10 weeks
Exercise Capacity - 6-Minute Stepper Test (6MST)	Exercise capacity will be assessed using the 6-Minute Stepper Test (6MST) before and after the rehabilitation program. The outcome is the number of steps completed during the test over 6 minutes. Higher values indicate better exercise capacity.	8 to 10 weeks
Exercise Capacity - 1-Minute Sit-to-Stand Test (1STS)	Exercise capacity will be assessed using the 1-Minute Sit-to-Stand Test (1STS) before and after the rehabilitation program. The test measures the number of sit-to-stand repetitions completed in 1 minute, with higher values indicating greater exercise capacity.	8 to 10 weeks
Health Status	Health status will be assessed using the Chronic obstructive pulmonary disease Assessment Test (CAT) before and after the rehabilitation program and after 1 year of the enrollement date. The score ranges from 0 to 40, with higher values indicating greater impairment of health status. The established minimal clinically important difference for this questionnaire is -2.5 points.	8 to 10 weeks
Respiratory Quality of Life	Assessed using the Visual Simplified Respiratory Questionnaire (VSRQ). The score ranges from 0 to 80, with higher values indicating greater quality of life. The established minimal clinically important difference for this questionnaire is 3.4 points.	8 to 10 weeks
Psychological Status - Anxiety	Symptoms of anxiety will be assessed using the Hospital Anxiety and Depression questionnaire, anxiety subscore, before and after the rehabilitation program and after 1 year of the enrollement date. The score ranges from 0 (best) to 21 (worst). The pre-specified minimal clinically important difference is set at -1.5 point.	8 to 10 weeks
Psychological Status - Depression	Symptoms of anxiety will be assessed using the Hospital Anxiety and Depression questionnaire, anxiety subscore, before and after the rehabilitation program and after 1 year of the enrollement date. The score ranges from 0 (best) to 21 (worst). The pre-specified minimal clinically important difference is set at -1.5 point.	8 to 10 weeks

Collaborators and Investigators

• Sponsor: ADIR Association
• Investigators: Principal Investigator: Tristan Bonnevie, ADIR Association

Study record dates

Study Major Dates

• Study Start (Actual): September 1, 2025
• Primary Completion (Actual): June 1, 2026
• Study Completion (Estimated): June 1, 2027

Study Registration Dates

• First Submitted: June 22, 2026
• First Submitted That Met QC Criteria: June 30, 2026
• First Posted (Actual): July 7, 2026

Study Record Updates

• Last Update Posted (Actual): July 7, 2026
• Last Update Submitted That Met QC Criteria: June 30, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Telerehabilitation; Pulmonary rehabilitation; Chronic Obstructive Pulmonary Disease; Chronic respiratory diseases; Digital Health Technologies; Private Practice Physiotherapy
• Additional Relevant MeSH Terms: Pathologic Processes; Chronic Disease; Disease Attributes; Respiratory Tract Diseases; Lung Diseases; Lung Diseases, Obstructive; Pathological Conditions, Signs and Symptoms; Pulmonary Disease, Chronic Obstructive; Respiration Disorders
• Other Study ID Numbers: DIGILIB-RR

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Data will be made available upon reasonable request for research purposes after publication. This includes de-identified data related to demographic characteristics, as well as endpoints published either in the main manuscript or any supplemental data. Requests should be sent to t.bonnevie@adir-hautenormandie.com
• IPD Sharing Time Frame: Data will be made available after publication.
• IPD Sharing Access Criteria: Data will be made available upon request, for research purpose. Request should be send to t.bonnevie@adir-hautenormandie.com

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No