Background and Objectives: Chronic Obstructive Pulmonary Disease (COPD) is the third most common cause of death globally. Pulmonary rehabilitation (PR) programmes are important to reduce COPD symptoms and improve the quality of life of people with COPD. Digital health interventions have recently been adopted in PR programmes, which allow people with COPD to participate in such programmes with low barriers. The aim of this study is to review and discuss the reported effects of digital health interventions on PR outcomes in people with COPD. Materials and Methods: To achieve the study goals, a systematic literature search was conducted using PubMed (MEDLINE), CINAHL, AMED, SPORTDiscus and the Physiotherapy Evidence Database. Randomised clinical trials (RCTs) were included if they met specified criteria. Two reviewers independently checked titles, abstracts, and performed full-text screening and data extraction. The quality assessment and risk of bias were performed in accordance with the PEDRO scale and Cochrane Risk of Bias tool 2, respectively. Results: Thirteen RCTs were included in this systematic review with 1525 participants with COPD. This systematic review showed the potential positive effect of digital health PR on the exercise capacity—measured by 6- and 12-min walking tests, pulmonary function, dyspnoea and health-related quality of life. There was no evidence for advantages of digital health PR in the improvement of anxiety, depression, and self-efficacy. Conclusions: Digital health PR is more effective than traditional PR in improving the pulmonary and physical outcomes for people with COPD, but there was no difference between the two PR programmes in improving the psychosocial outcomes. The certainty of the findings of this review is affected by the small number of included studies.

Asthma is a chronic respiratory disease that significantly impacts quality of life. Pulmonary rehabilitation has been shown to improve lung function and symptoms in asthma, but its adoption is limited due to accessibility and patient engagement challenges. Virtual reality (VR) and videogaming technologies have emerged as potential tools to enhance pulmonary rehabilitation by providing an engaging and interactive environment. This systematic review aimed to evaluate the effectiveness, feasibility, safety, and patient engagement of VR and videogaming in pulmonary rehabilitation for individuals with asthma. A comprehensive search of seven electronic databases (PubMed, Embase, CINAHL, Cochrane, AMED, SPORTDiscus and PEDro) was conducted to identify studies that included VR and videogaming interventions. Studies included participants with asthma and used VR or videogaming as part of pulmonary rehabilitation. Data extraction focused on intervention types, clinical outcomes, patient engagement, and safety. Five studies were included in the final review and involved 104 participants. The studies implemented different digital tools, including the InSpire System, and games such as “Reflex Ridge” and “Serious Games”. VR and videogaming interventions improved asthma control, lung function, and exercise capacity. High levels of patient engagement and adherence were reported, with no adverse events across the trial. VR and videogaming show promise as effective, feasible, and safe tools to enhance pulmonary rehabilitation in individuals with asthma. However, the heterogeneity of studies limited the ability to draw definitive conclusions, with further research needed using standardized outcomes.

Background and Objectives: Robotics is commonly used in the rehabilitation of neuro-musculoskeletal injuries and diseases. While in these conditions, robotics has clear benefits, it is unknown whether robotics will also enhance the outcome of cardiac rehabilitation. This systematic review evaluates the use of robotics in cardiac rehabilitation. Methods: A systematic literature search was conducted using PubMed (MEDLINE), CINAHL, AMED, SPORTDiscus, and the Physiotherapy Evidence Database. Longitudinal interventional studies were included if they met specified criteria. Two reviewers independently conducted title, abstract, and full-text screening and data extraction. The quality assessment and risk of bias were conducted according to the PEDRO scale and Cochrane Risk of Bias tool 2, respectively. Results: Four trials were included in this review out of 60 screened studies. The quality of the included studies was good with a low risk of bias. The trials used different robotic systems: Lokomat^® system, Motomed Letto/Thera Trainer tigo, BEAR, and Myosuit. It was found that interventions that included the use of robotic assistance technologies improved the exercise capacity, VO₂ max/peak, left ventricular ejection fraction, QOL, and physical functioning in people with cardiac diseases. Conclusions: Robotic assistance technologies can be used in cardiac rehabilitation programs. Further studies are needed to confirm the results and determine whether the use of robotics enhances intervention outcomes above standard interventions.

Background: Body contouring surgery for the removal of the 11th and 12th ribs is undertaken for aesthetic appeal in female and transgender populations. The potential adverse effects of the surgery on lung function and respiratory muscle strength have not been previously studied. Therefore, this study aimed to determine the effects of ‘Ant-waist’ surgery on lung function and respiratory muscle strength in individuals who had undergone surgery. Methods: This was a cross-sectional study with two groups, an Anti-waist group who had undergone surgery and an age and gender matched control group. Participants performed lung function tests to determine measurements of FEV1, FVC, FEV1/FVC, PEF, MIP, and MEP. Independent t-tests were performed to determine between-group differences in outcomes and Pearson's correlation coefficients determined the relationship between lung function and respiratory muscle strength, and number of years since surgery. Results: There was a significant between-group difference in FEV1 (-0.83; 95%CI -1.30, -0.36; p<0.001), FEV1%pred. (-34.91; 95%CI -48.92, -20.90; p<0.001), FVC%pred. (-22.73; 95%CI -32.84, -12.62; p<0.001), PEF%pred. (-44.18; 95%CI -61.52, -26.84; p<0.001) and MEP (-68.27; -102.48, -34.07; p0.5) between the number of years after surgery and FEV1 (p=0.002), FEV1%pred. (p=0.0001); and PEF%pred. (p=0.032). Conclusions: This study has identified that aesthetic surgery for the removal of ribs 11 and 12 had a significant adverse effect on lung function and respiratory muscle strength in Jordanian females. The potential adverse effects should be carefully explained by surgeons to patients considering the surgery.

Background: Cardiovascular diseases remain a leading cause of global morbidity and mortality. Cardiac rehabilitation (CR), particularly cardiac physiotherapy, is crucial for secondary prevention; yet access is suboptimal, especially for patients in rural and underserved populations due to logistical and socioeconomic barriers. Telehealth offers a promising solution to address these disparities. Objective: This systematic review aimed to synthesize evidence on the effectiveness, feasibility, and acceptability of telehealth-delivered cardiac physiotherapy interventions in rural and underserved populations and identify the associated barriers and facilitators. Methods: A comprehensive search was conducted across multiple databases. Studies investigating telehealth-delivered cardiac physiotherapy in rural/underserved populations were included. Due to heterogeneity in study designs, interventions, and outcomes, a narrative synthesis was performed. Qualitative and quantitative data were extracted on effectiveness, feasibility, acceptability, barriers, and facilitators. Results: Nine studies were included, employing diverse designs (randomized controlled trials, multimethod, feasibility, qualitative, codesign, and mixed methods). Telehealth-delivered cardiac physiotherapy demonstrated effectiveness in improving exercise capacity, cardiac risk profiles, weight management, and quality of life. It also enhanced CR attendance and completion rates. High feasibility and acceptability were reported, with patients valuing convenience and home access. Key facilitators included personalized support, staff adaptability, and codesign approaches. Persistent barriers included digital literacy, technological infrastructure limitations, socioeconomic factors, staffing issues, and potential patient isolation. Conclusion: Telehealth-delivered cardiac physiotherapy holds significant promise for expanding access and improving outcomes for rural and underserved populations. While effective and acceptable, successful implementation requires addressing digital, technological, and socioeconomic barriers. Leveraging identified facilitators and designing patient-centered interventions are crucial for equitable cardiovascular care.