Physical activity is increased by a 12 week semi-automated telecoaching program in patients with COPD, a multicenter randomized controlled trial

Demeyer, Heleen, Louvaris, Zafeiris, Frei, A., Rabinovich, Roberto, de Jong, Corina, Gimeno-Santos, Elena, Loeckx, Matthias, Buttery, S. C., Rubio, N., Van der Molen, T., Hopkinson, Nicholas, Vogiatzis, Ioannis, Puhan, M. A., Garcia-Aymerich, Judith, Polkey, M. I. and Troosters, Thierry (2017) Physical activity is increased by a 12 week semi-automated telecoaching program in patients with COPD, a multicenter randomized controlled trial. Thorax, 72 (5). pp. 415-423. ISSN 0040-6376

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Abstract

Rationale
Reduced physical activity (PA) in patients with COPD is associated with a poor prognosis. Increasing PA is a key therapeutic target, but thus far few strategies have been found effective in this patient group.
Objectives
To investigate the effectiveness of a 12 week semi-automated telecoaching intervention on PA in COPD patients in a multicenter European RCT.
Methods
343 patients from 6 centers, encompassing a widespectrum of disease severity, were randomly allocated to either a usual care group (UCG) or a telecoaching intervention group (IG) between June and December 2014. This 12 weeks intervention included an exercise booklet and a step counter providing feedback both directly and via a dedicated smartphone application. The latter provided an individualized daily activity goal (steps) revised weekly and text messages as well as allowing occasional telephone contacts with investigators. Physical activity was measured using accelerometry during 1 week preceding randomization and during week 12. Secondary outcomes included exercise capacity and health status. Analyses were based on modified intention-to-treat.
Main results
Both groups were comparable at baseline in terms of factors influencing PA. At 12 weeks, the intervention yielded a between group difference of mean, 95% CI [ll-ul] +1469, 95% CI [971 – 1965] steps.day-1 and +10.4, 95% CI [6.1 - 14.7] min.day-1 moderate physical activity; favoring the IG (all p≤0.001). The change in six minute walk distance was significantly different (13.4, 95% CI [3.40 - 23.5]m, p<0.01), favoring the IG. In IG patients an improvement could be observed in the functional state domain of the CCQ (p=0.03), when compared to UCG. Other health status outcomes did not differ.
Conclusions
The amount and intensity of PA can be significantly increased in COPD patients using a 12 week semi-automated telecoaching intervention including a step counter and an application installed on a smartphone.
Trial registration
NCT02158065 (clinicaltrials.gov)

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