Abstract Introduction Pulmonary rehabilitation (PR) is a cornerstone for chronic obstructive pulmonary disease (COPD) management but is underutilized. Music has been recognized for its physiological and psychological benefits, potentially bridging this gap. This study investigated the efficacy of smartphone application-based music-facilitated multicomponent PR on exercise capacity in COPD patients. Methods A three-arm, parallel-group, multicenter randomized controlled trial was conducted across 5 centers in China. Patients with moderate to severe stable COPD were recruited and randomly assigned to three groups: multi-module training (MT) (including both rhythm-guided walking and singing training), rhythm-guided walking (RW) alone, or usual care (UC). Patients in the MT and RW groups received individualized, progressive 12-week online home-based training through a smartphone application, specifically designed as a digital solution for rehabilitation in this study, featuring a rhythm-guided walking program, a singing training program, and an educational module. The primary outcome was the distance achieved in the incremental shuttle walking test (ISWT) at 12 weeks after randomization, a widely recognized measure of exercise capacity. Secondary outcomes included dyspnea, quality of life, and pulmonary function. The study protocol was approved by an institutional review board (2022-KY-024) and registered at ClinicalTrials.gov (NCT05832814). The primary outcome was evaluated by a linear mixed model incorporating all timepoints. Results Seventy patients screened met the eligibility criteria and were randomized to the MT (36%), RW (33%), or UC(32%), all of which were included in the the modified intention-to-treat analysis. At 12 weeks, the ISWT distance was significantly greater for the MT compared to the UC (mean difference (MD): 56.35 m; 95% CI: 6.66 to 106.04 m; p = 0.03; Cohen’s d = 0.3), with the difference being clinically meaningful (Figure 1). The modified Medical Research Council score (MD: -0.44; 95% CI: -0.80 to -0.08; p = 0.01), the COPD Assessment Test score (MD: -3.23; 95% CI: -6.18 to -0.29; p = 0.03), the Hospital Anxiety and Depression Scale-Anxiety score (MD: -2.31; 95% CI: -3.99 to -0.63; p = 0.008) and inspiratory capacity (MD: 15.98%pred; 95% CI: 4.76 to 27.21%; p = 0.007) also improved significantly in MT compared with UC. Compared with the RW, MT was significantly better in improving the dyspnea. These differences were not observed between the RW and the UC. Conclusion Our study demonstrates that a 12-week music-facilitated homed-based PR program (including tempo-guided walking and singing) based on mobile health technology results in clinically meaningful improvements in exercise capacity for COPD patients. This abstract is funded by: None
Shi et al. (Fri,) studied this question.