Online rehab program for rural lung patients to expand across Maritimes

When Lily MacDonald first signed in to an online workout session for women with COPD, she was sure she wasn't going to like it. She couldn't imagine doing an effective workout at her kitchen table.

"At first I thought, 'How can I exercise, what am I going to do?'" said MacDonald, who lives in Glace Bay, N.S. 

She was one of the first participants in a pilot project to offer virtual physical rehabilitation to lung patients in rural parts of the province.

The project went so well it will expand across the Maritimes this fall.

"I felt great, I really did," MacDonald said. "As it happens, you live by yourself, you have no motivation, but I started back into exercising."

Nova Scotia Health estimates that 86,000 people — or 13 per cent of the population — have chronic obstructive pulmonary disease, which is often caused by exposure to smoke. Those rates are some of the highest in the country.

That worried Carley O'Neill, an assistant professor in Acadia University's kinesiology program and a clinical exercise physiologist. She says COPD patients often complain of being out of breath.

"Exercise can really help to reduce that symptom," she said. "That's really going to help slow the rate of progression for this condition."

Living in Wolfville, O'Neill saw the limitations of rehab programs that were limited to those who could attend in-person.

She said a lot of people in rural areas were not getting the support they needed because they couldn't get to class.

She worked with one of her students, Amanda Daniels, and the two launched a virtual class. They offered it to about 50 women across the province. The participants ranged in age from 43 to 86.

"We wanted to start small before we upscale it to see what we could do," she said.

The women were divided into small groups and met online twice a week to work out from home.

They were mailed packages that included workout bands and pulse oximeters, small devices that monitor oxygen levels throughout the workout.

Then they were encouraged to use small weights.

Daniels suggested lifting soup cans or water bottles if they didn't have anything else. The key was that the program needed to be free, so cost wouldn't limit participation.

Daniels, who is from Labrador City, N.L., knows all too well how hard it is to get care in rural areas, so she was eager to support the women.

"Many of them live alone," she said. "Many of them don't have family members nearby to help care for them. Some of them are scared to go to the grocery store because they feel too breathless to walk around the store or get out for a walk or anything like that.

"Being able to sit at home and talk to people, it's life-changing for them."

This wasn't MacDonald's first attempt at a rehabilitation program. She participated in Membertou a few years ago, but she could no longer get a drive when the classes moved to Sydney River.

MacDonald was self-conscious about going online, but she quickly came to love the Zoom meetings.

"If you were late signing in, they would either call you or buzz you … because you knew somebody was out there who was going to care if you were there or not," she said.

"It's the accessibility. Just to be able to get up out of bed, get ready and sit in front of the community and you're in class."

This was the benefit that Carley O'Neill and Amanda Daniels didn't expect.

While the program is intended to help someone's physical health, they loved that it also helped people's mental health.

"Oftentimes what they say they've enjoyed the most has been the community and the friendships they build, which … hurts my heart a little bit because I'm an exercise physiologist and the exercise isn't really what's wooing them," said O'Neill. "But it's been a really positive outcome."

O'Neill has now received a new grant from the Lung Association of Nova Scotia and Prince Edward Island. Classes in the fall will open up to people of all genders and in the three Maritime provinces.

She'll do a feasibility study on the project, and she's hoping it will eventually be a permanent option for lung patients across rural Canada.