Stretching their limits

Virtual pulmonary rehabilitation programs have been offered for a long time across the country and the province, and studies comparing virtual programs with in-person rehabilitation show comparable results for participants.  

“Our program is different in that we focus primarily on exercise training and are specifically trying to target people in rural areas. Involving our student trainers is also a key piece of the program. It provides students with a real-world learning experience working with individuals with chronic disease,” she explains.

Amanda Daniels (’25) ran many of the sessions and did most of the data collection for her Honours research.

“As a Kinesiology student at Acadia, we gain plenty of experience working with participants in-person, where we are able to provide hands-on directions and use body language and physical cues for guidance,” Amanda says.

“After my first couple of virtual sessions, I quickly realized that while it is not all that much different regarding the sharing knowledge, interpersonal skills, and physical activity demonstration and promotion, I would need to adapt my communication skills to keep participants engaged.”

“That meant counting their reps with them, perhaps offering more demonstrations and explanations. This has even helped me to improve my skills while working with participants in-person!”

Ebe Otoikhine (’25) also led some of the sessions and shares similar learnings.

“In person, it’s much easier to adjust form, physically demonstrate exercises, and pick up on small non-verbal cues. Virtually, I had to place much more emphasis on clearly explaining each movement and often had to exaggerate my demonstrations to make sure participants could follow along,” she says.

Flexing their social skills

“What surprised me most was the group dynamics and fellowship. I was not sure whether a virtual program would be able to offer the same social benefits as an in-person program. I was quickly proven wrong. Our findings have shown that social interaction is by far the most enjoyed aspect of our program,” Amanda says.
Despite talking through an online call, from different regions across Nova Scotia, participants shared that they really enjoyed joining the call and completing the exercise with others, as well as learning more about COPD.

“Being able to relate to the others and develop these friendships is huge. These folks are often scared or reluctant to leave the house and are very prone to social isolation due to the presence of symptoms such as coughing, wheezing, and breathlessness. I was surprised at how quickly these connections formed. A program that offers such companionship is life changing for participants.”

Ebe agrees. “Despite busy schedules, personal challenges, and varying levels of comfort with technology and exercise, these women consistently showed up! And not just for their own health, but to support each other. Over time, you could really see how much they valued the group. They checked in with each other before sessions, encouraged one another during tough exercises, and openly shared experiences during the education pieces.”

“It was heartwarming to see, these participants are who really made this study great.”

The team hopes that programs like this can create an opportunity to provide more support in rural communities without the need for physical space since all classes are virtual. They would address some of the most common barriers to in-person attendance for physical rehabilitation: accessibility, transportation, and cost.

“Working with participants virtually opened my eyes to the reality of what the Canadian healthcare system is today, and how we can make a difference. We can build on our ability to work with patients while tackling the lack of accessibility to healthcare facilities,” Amanda says.

Stepping up to scale up

The data from this pilot project showed that the program is feasible, so Carley applied for and received funding to expand the project across the Maritimes and to all genders. Starting in September, Carley and a new batch of students will begin the sessions.

The program will run in line with the academic year to allow more students to become involved. It will be open to 3rd and 4th year undergraduate kinesiology students to take for course credit. Each student will lead a small group of two to four participants through the twice weekly exercise program and be responsible for data collection and monitoring breathlessness, oxygen saturation, and exertion levels during each session.

“Since I had previously worked with Carley on a research project focused on the barriers to pulmonary rehabilitation for women, being part of this virtual COPD study felt like a full-circle moment,” Ebe says of her experience in the pilot project.

“I went from identifying gaps in access to actively helping implement a solution and seeing firsthand how that solution could impact lives. This experience helped solidify what I had been learning in the last four years: the importance of evidence-based practice and the real-world application of exercise prescription. I can confidently say it was one of the most meaningful and hands-on learning opportunities I had during my time at Acadia,” she says.

Just getting warmed up

Carley plans to recruit 50 people into the new program, and since some rural communities may not have reliable internet, the new funding is providing participants with a portable wifi adapter.

“The goal is to reduce as many barriers as we can to try and access these communities that are largely under-served and overlooked in clinical research, exercise-based rehabilitation, and exercise programming,” she explains.

“The program has been very well received among participants. The feedback from them personally about how much fun they've had and how happy they've been to meet new people with the same condition has been overwhelming!” Carley says.

The initial pilot was funded through a New Health Investigator grant through Research Nova Scotia. The next phase is made possible with funding from LungNSPEI.