Purposeful physical activity in COPD patients comparing standard and web based pulmonary rehabilitation

Abstract

Introduction: Pulmonary Rehabilitation (PR) increases exercise capacity, with less clear evidence for Physical Activity (PA) (Gimeno-Santos E, et al. Thorax. 2014 Aug; 69(8):731-9), we sought to assess the effectiveness of standard versus web based PR with respect to changes in PA.

Method: Patients with COPD were randomised to standard (n=51) or web (n=52) PR for 7 weeks in a feasibility study. Accelerometers (Sensewear®) were worn pre and post intervention, PA was measured as steps/hr and mean bouts of moderate activity for 2, 5, 10 and 20 mins/hr. Measures were derived for patients with at least 8 hrs of data/day for ≥4 days using R language statistical software.

Results: Baseline characteristics did not differ significantly between groups. Complete data for web (n=20) and standard (n=34) groups showed a non-significant increase in steps/24hr for the web group compared with standard (P=0.37), comprising mainly 2 min bouts of PA. In contrast, the standard group increased 20 min bouts of purposeful activity by 10% although non-significant (P=0.26). Whilst age, BMI and FEV1% predicted were significantly correlated with 10 min bouts of PA at baseline, this was eliminated post intervention for age and FEV1, but not for BMI

Conclusions: We detected a non-significant difference in the pattern of PA between standard and web groups, standard PR was associated with more purposeful bouts. Effects of age and FEV1 on physical activity can be overcome by taking part in rehabilitation, but BMI remains unaffected.