The document outlines the importance and effectiveness of tele-pulmonary rehabilitation programs like Respirehab for patients with COPD and those recovering from COVID-19-related impairments. It highlights the accessibility, convenience, and positive outcomes of the program, which includes significant improvements in exercise capacity and symptom management. Developed by Reliva, the program integrates telemedicine to deliver personalized care and support via an app, ensuring patient compliance and enhanced recovery.

1. Private & Confidential

2. Pulmonary Rehab helps pulmonary patients
• NICE (National Institute for Health and Care Excellence, UK) Guidelines state1
• Make pulmonary rehabilitation available to all appropriate people with COPD (see recommendation 1.2.82), including
people who have had a recent hospitalisation for an acute exacerbation
• British Thoracic Society states2
• Those discharged from hospital after treatment for COVID-19, and potentially those managed in the community are likely
to report significant ongoing physical, functional, and psychological impairment. There is a need to develop an
appropriately targeted and safe rehabilitation programme to support the recovery of this population.
• American Thoracic Society3
• Pulmonary rehabilitation is now recommended in published disease management guidelines not only for COPD, but also
in those for interstitial lung disease and pulmonary hypertension. .
Respirehab makes quality pulmonary rehabilitation accessible,
affordable and convenient for patients
Developed by ReLiva Physiotherapy & Rehab
1. https://www.nice.org.uk/guidance/ng115/chapter/Recommendations#managing-stable-copd
2. https://www.brit-thoracic.org.uk/about-us/covid-19-information-for-the-respiratory-community/
3. https://www.thoracic.org/members/assemblies/assemblies/pr/
Please see Annexure for evidence for Tele-Pulmonary Rehabilitation

3. Respirehab: Tele-Pulmonary Rehab Program
• A tele-pulmonary rehab program developed &
run by cardio-respiratory physiotherapists of
ReLiva
• Focus:
A. Increase exercise capacity
B. Cough education & drainage techniques
C. Reduce Symptoms
D. Better energy & stamina
E. Education & Self management
Supported by Respirehab app for patient
convenience and compliance
Excellent recovery for patients
On Average: 68% improvement in SGRQ, all patients reached level 1 on Dyspnea scale, 6% improvement in SPO2 readings

4. Respirehab: Pulmonary Rehab made accessible
• Respirehab program (https://respirehab.com) has been
developed to deliver safe & convenient pulmonary rehab
• Engaged with COVID patients of Masina Hospital, Lifepoint
Hospital, Noble Hospital and KEM Hospital
• Findings being published in Indian Journal of Physiotherapy &
Occupational Therapy, January issue
• Respirehab app supports the patients in their treatment
• Respirehab app available on play store (Android)
• https://play.google.com/store/apps/details?id=com.shhs.reliva.respire
hab
• Provides daily exercise/ breathing practice program with videos +
reminders
• Communicate with physiotherapist & regular follow ups
• Provide daily feedback for sessions and general health

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Telerehab for pulmonary patients
• A personalized pulmonary rehabilitation program delivered through telemedicine
• Cardiorespiratory Physiotherapist led program
• Focused on recovery, education and empowerment
• Continuous Clinical relationship
• Breathing practices, progressive & measured exercises, techniques for self management
• Educational videos
• Regular follow-ups and compliance calls
• Detailed assessment and evaluation during course of program
Evidence Based Cost effectiveAccessibleSafe

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Telerehab, a safe & effective choice
• It is a convenient option for patients which can help them improve their lung functions, physical
health and psychosocial wellbeing remotely.
• Helps respiratory therapist to treat patients without coming in direct contact with the patient. In
current context, eliminates the risk of getting exposed to corona virus.
• Saves travel cost & time.
• For patients, reduces the exposure to other pathogens and pollution which could be present
otherwise while visiting to a clinic/hospital.
• More Compliance because accessible from phone.

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Outcomes
• Excellent recovery for patients (post COVID
rehab)
• Impact measurement on following scales
• MMRC Dyspea scale
• O2 Dependency
• St Georege Respiratory Questionnaire
• Exercise capacity/ ADL
Physiotherapy Care for In-Patients (IPD) also possible

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Great Outcomes: Tele-COVID Rehab
Excellent recovery for initial patients
On Average: 68% improvement in SGRQ, all patients reached level 1 on Dyspnea scale,
6% improvement in SPO2 readings
www.respirehab.com

9. Private & Confidential
Outcomes: being published in IJPOT
Excellent recovery for patients
On Average: 68% improvement in SGRQ, all patients reached level 1 on Dyspnea scale,
6% improvement in SPO2 readings
www.respirehab.com

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Great Outcomes: Patient Testimonials
https://www.youtube.com/watch?v=XmRDkqW0Ptw https://www.youtube.com/watch?v=ioTp9_-QBbw

11. About ReLiva, the physiotherapy specialist
• ReLiva is a physiotherapy specialist and leading chain of physiotherapy &
rehabilitation clinics
• Offers comprehensive physiotherapy
• Focused on sustainable solutions through physiotherapy techniques
• Believe in recovery via empowerment – educate, involve and recover,
through evidence based practices
• 47 clinical locations in 10 cities in India
• Mumbai, Bengaluru, Pune, Hyderabad, Mysore, Chennai, New Delhi, Kanpur,
Jaipur, Navi Mumbai
• Online Telephysio access across the world
Thanks

12. Annexure: Reference/ Evidence for tele-pulmonary rehab (1)
1. Title: Online Versus Face to Face Pulmonary Rehabilitation for Patients with COPD: A Randomised
Controlled Trial
• Publication: BMJ Open 2017;7:e014580. doi: 10.1136/bmjopen-2016-014580
• Abstract: A six week programme of online supported PR was not-inferior to a conventional model delivered in face-
to-face sessions in terms of effects on six minute walk test distance, and symptom scores and was safe and well
tolerated in the context of this study. This mode of PR delivery offers the opportunity to extend the provision of this
evidence based and guideline mandated intervention for patients with COPD with functional limitation as part of
routine care
• Link: https://bmjopen.bmj.com/content/7/7/e014580
2. Title: Telerehabilitation in people with chronic obstructive pulmonary disease (COPD): A randomised
controlled trial
• Publication: European Respiratory Journal 2016 48: PA2065; DOI: 10.1183/13993003.congress-2016.PA2065
• Conclusion: Telerehabilitation is an effective therapy to improve endurance exercise capacity and self-efficacy in
people with COPD.
• Link: https://erj.ersjournals.com/content/48/suppl_60/PA2065

13. Annexure: Reference/ Evidence for tele-pulmonary rehab (2)
3. Title: Telerehabilitation for Chronic Obstructive Pulmonary Disease Patients: An
Underrecognized Management in Tertiary Care
• Publication: Indian J Palliat Care. 2018 Oct-Dec; 24(4): 529–533.
• Conclusion: Telerehabilitation is an excellent rehab measure where the COPD patients exercise at his home, while
expertise from the tertiary care centers monitors the rehab sessions remotely
• Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6199829/
4. Title: Digitalizing multidisciplinary pulmonary rehabilitation in COPD with a smartphone
application: an international observational pilot study
• Publication: Int J Chron Obstruct Pulmon Dis. 2018; 13: 3831–3836.
• Conclusion: Digitalizing PR with a smartphone app is feasible and accepted by selected patients. The app leads to
short-term improvement of health-related quality of life in patients completing a 20-day core program.
• Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6260122/

14. Annexure: Reference/ Evidence for tele-pulmonary rehab (3)
5. Title: Home-based maintenance tele-rehabilitation reduces the risk for acute exacerbations of
COPD, hospitalisations and emergency department visits
• Publication: European Respiratory Journal 2017 49: 1602129; DOI: 10.1183/13993003.02129-2016
• Abstract: Home-based maintenance tele-rehabilitation is equally effective as hospital-based, outpatient,
maintenance PR in reducing the risk for acute COPD exacerbation and hospitalisations. In addition, it encounters a
lower risk for ED visits, thereby constituting a potentially effective alternative strategy to hospital-based, outpatient,
maintenance PR.
• Link: https://erj.ersjournals.com/content/49/5/1602129
6. Title: People attending pulmonary rehabilitation demonstrate a substantial engagement with
technology and willingness to use telerehabilitation: a survey
• Publication: Journal of PhysiotherapyVolume 63, Issue 3, July 2017, Pages 175-181
• Conclusion: People attending metropolitan pulmonary rehabilitation, maintenance exercise classes and support
groups had substantial technology engagement, with high device access and use, and good self-rated technology
competence. The majority of participants were willing to use telerehabilitation, especially if they were regular users
of technology devices
• Link: https://www.sciencedirect.com/science/article/pii/S1836955317300620