Hybrid Tele-Rehabilitation in the Management of Pediatric Chronic Suppurative Lung Diseases: Study Protocol for a Randomized Controlled Trial

Background: The pediatric population with chronic suppurative lung diseases (CSLDs) presents with a clinical profile of persistent productive cough and impaired airway clearance, which leads to reduced exercise capacity and physical activity (PA). The main objective of this research is to evaluate the effect of a 12-week intervention that combines airway clearance techniques (ACTs) and exercise training delivered through synchronous (videoconferencing) and asynchronous implementation at home, supported by an informative, specially designed website and supervised by a physiotherapist on exercise capacity. The secondary objective is to assess adherence to the ACT performance. The hypothesis of the study is that this hybrid tele-rehabilitation program will improve functional and exercise capacity, as well as compliance with ACTs, compared to the usual care. Methods: Thirty-two children with CSLDs (other than cystic fibrosis) will be randomly assigned to either the intervention group (home-based, synchronous, and asynchronous ACTs and exercise training) or the control group (usual care). An assessor blind to group allocation will measure the modified shuttle walk test, 6-minute walking test, Chester step test, respiratory muscle strength, handgrip, pulmonary function, PA, sedentary behavior, and quality of life at baseline, at the end of the intervention (3 months), and 6 months after completion. Discussion: This study introduces a hybrid (synchronous and asynchronous) tele-rehabilitation program, aiming to improve physical capacity and adherence to physiotherapy management for pediatric CSLD populations.