**12. Future directions**

Pulmonary rehabilitation has a major role in the management of patients with chronic lung conditions especially COPD. The need for more convenient and efficient programs using new technology would be beneficial for patients. Telerehabilitation to deliver rehabilitation services over telemedicine using internet or phone can provides services to patients who live in remote areas without access to transportation. Tele-rehabilitation allows video conferencing between a central control unit and a patient at home. This will also deliver health services to patients with disability who cannot travel long distances for rehabilitation programs. Both mobile phones and video conferencing have used in few studies deliver rehabilitation services. The studies have demonstrated good compliance, decrease in exacerbations and hospitalizations, improved exercise capacity and quality of life [154, 155]. Benefits of telemonitoring in COPD patients have been described in a systemic review that showed decrease in hospitalizations and emergency room visits using telephone support for telerehabilitation [156].
