Web-based pulmonary rehabilitation resulted in a nonsignificant 12% increase in steps per day compared to a 2% increase with conventional pulmonary rehabilitation (P=0.20).
RCT (n=103)
Open-label
1:1 ratio using a web-based program
No
Does web-based pulmonary rehabilitation improve physical activity compared to conventional pulmonary rehabilitation in patients with COPD?
Web-based and conventional pulmonary rehabilitation may have differing, though nonsignificant, effects on physical activity patterns in COPD patients.
Effect estimate: 12% increase vs 2% increase
Absolute Event Rate: 6112% vs 5409%
p-value: p=0.20
Background Pulmonary Rehabilitation (PR) increases exercise capacity, with less clear evidence regarding physical activity (PA). The World Health Organization recommends at least 150-300 minutes of moderate-intensity or 75-150 minutes of vigorous-intensity aerobic PA per week to reduce the risks of chronic disease. Objective The objective of this study was to assess the effectiveness of conventional PR versus web-based PR with respect to changes in PA. Methods Patients with COPD were randomized to either conventional PR classes (n=51) or a web-based PR program (n=52) for 7 weeks in a feasibility study. Accelerometers (Sensewear) were worn before and after the intervention, and PA was measured as steps per day and mean bouts of moderate activity for ≥2, ≥5, ≥10, and ≥20 minutes. Measures were derived for patients with ≥8 hours of data per day for ≥4 days, using the R package for statistical analysis. Variables were explored to examine their relationships with bouts of activity. Results Baseline characteristics did not differ significantly between groups. Complete PA data were available for the groups receiving web-based (n=20) and conventional (n=34) PR interventions. The web-based PR group demonstrated a nonsignificant increase in the number of steps per day, which mainly comprised short bouts of moderate to vigorous intensity PA when compared to the conventional PR group (P=.20). The conventional PR group demonstrated increased 20-minute bouts of PA by 49.1%, although this was not significant (P=.07). At baseline, age (r=–0.21, P=.04), BMI (r=–0.311, P=.004), and FEV1 (forced expiratory volume in 1 second; % predicted; r=–0.248, P=.048) were significantly correlated with 10-minute bouts of PA; however, this was not observed post intervention. Conclusions The analysis revealed a nonsignificant difference in the pattern of PA between groups receiving conventional vs web-based PR—the former being associated with an increase in 20-minute bouts, while the latter having demonstrated an increase in the number of steps per day. There appears to be a differing response emerging between the two interventions. Trial Registration International Clinical Trials Registry ISRCTN03142263; https://tinyurl.com/y4dmfyrb
Chaplin et al. (Tue,) conducted a rct in Chronic Obstructive Pulmonary Disease (COPD) (n=103). Web-based pulmonary rehabilitation vs. Conventional pulmonary rehabilitation was evaluated on Physical activity measured as steps per day (12% increase vs 2% increase, p=0.20). Web-based pulmonary rehabilitation resulted in a nonsignificant 12% increase in steps per day compared to a 2% increase with conventional pulmonary rehabilitation (P=0.20).