Supervised Home-Based Telerehabilitation for Idiopathic Pulmonary Fibrosis: A Pragmatic Service Evaluation in Routine Care with Detraining Follow-up

Vasileios Stavrou; Konstantinos Korakas; Glykeria Tsirimona; Eleni Karetsi; Antonios Charokopos; Zoe Daniil

doi:10.36141/svdld.2026.18236

Authors

Vasileios Stavrou Medical School, University of Cyprus
Konstantinos Korakas Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly
Glykeria Tsirimona Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly
Eleni Karetsi Respiratory Medicine Department, University General Hospital of Larissa, Greece
Antonios Charokopos Department of Respiratory Medicine, Medical School, University of Cyprus
Zoe Daniil Laboratory of Cardio-Pulmonary Testing and Pulmonary Rehabilitation, Respiratory Medicine Department, Faculty of Medicine, University of Thessaly

Keywords:

six minute walk test, emotional well being, pulse-respiration quotient

Abstract

Background and aim: This study examined the effects of a four-week tele-exercise rehabilitation program, delivered and monitored via the USTEP tele-exercise rehabilitation platform, followed by a four-week detraining period, on patients with idiopathic pulmonary fibrosis (IPF), using data from the in-house Stavrou IPF cohort

Methods: Thirteen participants were assessed at three time points (baseline: T0; post-intervention: T1; post-detraining: T2) using the following validated tools: the six-minute walk test (6MWT) to assess functional capacity, the SF-36 to assess quality of life, the HADS to assess anxiety and depression, and the cardiorespiratory parameters

Results: Adherence was excellent at 92%, with median 11/12 sessions undertaken and no exercise-related adverse events. Significant improvements were observed in physical function and symptoms following the tele-exercise program. The distance covered in the 6MWT increased by 8.4% from T0-T1 (p=0.004, d=−1.15) but then decreased slightly after the detraining period. SF-36 physical health scores improved after training (+5.2%) but then decreased sharply at T2 (p=0.004, d=1.17). Fatigue scores improved significantly after training (p=0.025, d=0.64) and pain perception decreased (p=0.030, d=0.65). HADS scores showed a significant improvement from T0-T1 (p=0.034, d=0.70). Notably, the pulse-respiration quotient (PRQ) changed significantly (χ²(2)=8.60, p=0.014), indicating improved autonomic integration following training that deteriorated during the detraining period.

Conclusions: These results suggest that even short-term supervised tele-exercise can produce measurable improvements in physical capacity, emotional health, and physiological regulation in patients with IPF. This supports its role as a viable remote pulmonary rehabilitation strategy

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