Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD

Original Research

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Authors: Huong Q Nguyen, Dawn P Gill, Seth Wolpin, et al

Published Date August 2009 Volume 2009:4 Pages 301 - 313

DOI: http://dx.doi.org/10.2147/COPD.S6643

Huong Q Nguyen¹, Dawn P Gill¹, Seth Wolpin¹, Bonnie G Steele², Joshua O Benditt¹

¹University of Washington, seattle, WA, USA; ²VA Puget Sound Health Care System, Seattle, WA, USA

Objective: To determine the feasibility and efficacy of a six-month, cell phone-based exercise persistence intervention for patients with chronic obstructive pulmonary disease (COPD) following pulmonary rehabilitation.

Methods: Participants who completed a two-week run-in were randomly assigned to either MOBILE-Coached (n = 9) or MOBILE-Self-Monitored (n = 8). All participants met with a nurse to develop an individualized exercise plan, were issued a pedometer and exercise booklet, and instructed to continue to log their daily exercise and symptoms. MOBILE-Coached also received weekly reinforcement text messages on their cell phones; reports of worsening symptoms were automatically flagged for follow-up. Usability and satisfaction were assessed. Participants completed incremental cycle and six minute walk (6MW) tests, wore an activity monitor for 14 days, and reported their health-related quality of life (HRQL) at baseline, three, and six months.

Results: The sample had a mean age of 68 ± 11 and forced expiratory volume in one second (FEV₁) of 40 ± 18% predicted. Participants reported that logging their exercise and symptoms was easy and that keeping track of their exercise helped them remain active. There were no differences between groups over time in maximal workload, 6MW distance, or HRQL (p > 0.05); however, MOBILE-Self-Monitored increased total steps/day whereas MOBILE-Coached logged fewer steps over six months (p = 0.04).

Conclusions: We showed that it is feasible to deliver a cell phone-based exercise persistence intervention to patients with COPD post-rehabilitation and that the addition of coaching appeared to be no better than self-monitoring. The latter finding needs to be interpreted with caution since this was a purely exploratory study.

Trial registration: ClinicalTrials.gov (NCT00373932).

Keywords: chronic obstructive pulmonary disease, physical activity, exercise persistence, pulmonary rehabilitation, cell phones

General overview: The purpose of this study was to test the feasibility of using cell phones to support exercise persistence in patients with COPD after pulmonary rehabilitation. Participants were randomly assigned to one of two programs for 6 months, MOBILE-Coached (n=9) or MOBILE-Self-monitored (n=8). The MOBILE-Coached program received more intensive follow-up. We found that all participants (mean age of 68; moderate to severe COPD) reported that logging their exercise and symptoms on the cell phone was easy and that keeping track of their exercise helped them remain active. There were no differences between groups in how well they performed on exercise tests and their quality of life but the MOBILE-Self-Monitored group showed a greater increase in their physical activity compared to the MOBILE-Coached group. These findings should be interpreted with caution due to the small sample size.