PICOS (population, intervention, comparison, outcome, study type) table for the search strategy

Description, inclusionExclusion criteriaOperational rules
PopulationAdults with primary diagnosis of CRDs
Age >18 years
Comorbidity will not be an exclusion criterion
Pregnant women and paediatric population
Rehabilitation provided to predominant condition is nonrespiratory conditions
Recovery from acute infections or injury (e.g. immediately post-COVID-19) until the condition has been stable for 6 months
Conference abstract
Lung cancer
Pulmonary hypertension
PR delivered to people with CRDs such as COPD, remodelled asthma, PIAT, bronchiectasis, ILD, CF, stable post-COVID-19 (but excluding post-ICU rehabilitation) will be studied. We will also include PR delivered to people with more than one CRD, or undifferentiated chronic respiratory conditions
Conference abstracts will be excluded, but will prompt a search for a subsequent published paper
InterventionHome-PR that comprises both exercise and at least one nonexercise component for a duration not less than 4 weeksFormal hospital or community medical centre-based programmesHome-PR: the key criterion is that the sessions are undertaken by individuals by themselves (although a family member may be involved) and typically at home. Apart from baseline and post-PR assessments, the patient does not attend a centre (either a hospital centre or a local “satellite” centre) and is not supervised face-to-face by a healthcare professional (although there may be remote communication from a healthcare professional for some or all of the session), and is not part of an “in-person” group
Exercise sessions typically include aerobic, endurance, resistance and reconditioning exercises, although local resources and preferences may include other exercise modalities. Nonexercise components commonly include patient education, energy conservation training, smoking cessation, psychological support, self-management skill development or other recognised PR interventions, along with optimisation of pharmacotherapy
ComparisonEither population receiving centre-PR or receiving usual careNo control groupCentre-PR: the key criterion is that the sessions are under direct healthcare professional's supervision. The “centre” can be in a hospital, community setting or remote facility. Centre-based sessions are normally group-based (although it is recognised that this may be modified in the context of a pandemic). Telehealth services where patients attend a supervised satellite centre would be considered as centre-PR
Usual care: the standard care received by individuals with CRD in the relevant healthcare system, but excluding the exercise components of PR
OutcomesEither one of the following outcome measures:
Functional exercise capacity
Additional outcome(s):
Uptake of the service, completion rates
Assessment of motivation/other intermediate outcome
Activities of daily living
Physical activity level
Symptom control
Psychological status
Healthcare burden, e.g. exacerbation rates, hospitalisation, etc.
Adverse effect
Not including HRQoL or any measurement of exercise capacity as outcomeAny validated instruments will be considered:
HRQoL: e.g. SGRQ, CRQ, EQ-5D
Functional exercise capacity: e.g. 6MWT, ISWT, ESWT. We will also include step tests and sit-to-stand tests that are sometimes used in home-PR assessments
Symptom control: e.g. mMRC, CCQ, Borg scale
Psychological status: e.g. HADS, PHQ-9, STAI, Beck's inventory tests
SettingAny settingsLow- or high-resource settings, irrespective of level of economies of the countries
Study designsRCTs, CCTsCohort study, case series, case reportWe will exclude studies that do not have a control group. We will consider RCTs to answer all of the three research questions (i.e. effectiveness, components and completion rate of home-PR), and consider CCTs to answer research questions 2 and 3
LanguageNo language restriction

CRD: chronic respiratory disease; COVID-19: coronavirus disease 2019; PR: pulmonary rehabilitation; PIAT: pulmonary impairment after tuberculosis; ILD: interstitial lung disease; CF: cystic fibrosis; ICU: intensive care unit; HRQoL: health-related quality of life; SGRQ: St George's Respiratory Questionnaire; CRQ: Chronic Respiratory Questionnaire; EQ-5D: EuroQol Five Dimension; 6MWT: 6-min walk test; ISWT: incremental shuttle walking test; ESWT: endurance shuttle walking test; mMRC: modified Medical Research Council dyspnoea scale; CCQ: Clinical COPD Questionnaire; HADS: Hospital Anxiety and Depression Scale; PHQ-9: Patient Health Questionnaire-9; STAI: State-Trait Anxiety Inventory; RCT: randomised controlled trial; CCT: clinical controlled trial. Reproduced from [36] with permission.