Background: Motor imagination (MI) and action observation (AO) are cognitive rehabilitation methods. There are no studies on the effectiveness of these methods in respiratory patients.

Aims: The aim of this study is to examine the effectiveness of telerehabilitation methods on exercise capacity, respiratory muscle fatigue, dyspnea and quality of life.

Methods: 23 severe COPD patients were randomly divided into two groups namely pulmonary (PTGr) and cognitive telerehabilitation (CTGr) groups. PTGr program was consist of warm-up, relaxation, breathing exercises, active cycle of breathing technique, peripheral muscle strengthening exercises and free walking. CTGr also received the same exercises program, but the strengthening exercises were also applied with the MI and AO methods as well as with active participation. The study outcomes were: the 6-Minute Walk Test Distance (6MWD), electromyography (EMG), Modified Medical Research Council (mMRC) Scale, and St. George Respiratory Questionnaire (SGRQ).

Results: Post-program, mean 6MWD (p=0.003) and SGRQ scores (symptom p=0.003, activity p=0.003, disease impact p=0.003, total score p=0.003) compared to pre-program statistically significant improvement was observed in both groups.  Significant improvement was found in the mean mMRC score only in the CTGr group (p=0.025). While statistically significant increases were observed in the PTGr group in EMG data, decreases were observed in the CTGr group (p<0.05).

Conclusions: Rehabilitation applied with mental practice methods can be a powerful alternative rehabilitation method in severe respiratory patients who cannot tolerate active exercise programs and/or have problems with referral to hospital.