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Title: | Physical activity is increased by a 12-week semiautomated telecoaching programme in patients with COPD: a multicentre randomised controlled trial |
Author: | Demeyer, Heleen Louvaris, Zafeiris Frei, Anja Rabinovich, Roberto Alejandro Jong, Corina de Gimeno Santos, Elena Loeckx, Matthias Buttery, Sara C. Rubio, Noah Van der Molen, Thys Hopkinson, Nicholas S. Vogiatzis, Ioannis Puhan, Milo A. García Aymerich, Judith Polkey, Michael I. Troosters, Thierry |
Keywords: | Condició física Pronòstic mèdic Physical fitness Prognosis |
Issue Date: | 30-Jan-2017 |
Publisher: | BMJ |
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 semiautomated telecoaching
intervention on PA in patients with COPD in a multicentre
European randomised controlled trial. METHODS: 343 patients from
six centres, encompassing a wide spectrum 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-week intervention included an exercise booklet and
a step counter providing feedback both directly and via a
dedicated smartphone application. The latter provided an
individualised daily activity goal (steps) revised weekly and
text messages as well as allowing occasional telephone contacts
with investigators. PA was measured using accelerometry during 1
week preceding randomisation 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 (lower limit - upper
limit; ll-ul) +1469, 95% CI (971 to 1965) steps/day and +10.4,
95% CI (6.1 to 14.7) min/day moderate PA; favouring the IG (all
p</=0.001). The change in 6-min walk distance was
significantly different (13.4, 95% CI (3.40 to 23.5) m,
p<0.01), favouring the IG. In IG patients, an improvement
could be observed in the functional state domain of the clinical
COPD questionnaire (p=0.03) compared with UCG. Other health
status outcomes did not differ. CONCLUSIONS: The amount and
intensity of PA can be significantly increased in patients with
COPD using a 12-week semiautomated telecoaching intervention
including a step counter and an application installed on a
smartphone. TRIAL REGISTRATION NUMBER: NCT02158065. 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 semiautomated telecoaching intervention on PA in patients with COPD in a multicentre European randomised controlled trial. Methods 343 patients from six centres, encompassing a wide spectrum 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-week intervention included an exercise booklet and a step counter providing feedback both directly and via a dedicated smartphone application. The latter provided an individualised daily activity goal (steps) revised weekly and text messages as well as allowing occasional telephone contacts with investigators. PA was measured using accelerometry during 1 week preceding randomisation 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 (lower limit – upper limit; ll-ul) +1469, 95% CI (971 to 1965) steps/day and +10.4, 95% CI (6.1 to 14.7) min/day moderate PA; favouring the IG (all p≤0.001). The change in 6-min walk distance was significantly different (13.4, 95% CI (3.40 to 23.5) m, p<0.01), favouring the IG. In IG patients, an improvement could be observed in the functional state domain of the clinical COPD questionnaire (p=0.03) compared with UCG. Other health status outcomes did not differ. Conclusions The amount and intensity of PA can be significantly increased in patients with COPD using a 12-week semiautomated telecoaching intervention including a step counter and an application installed on a smartphone. |
Note: | Reproducció del document publicat a: http://dx.doi.org/10.1136/thoraxjnl-2016-209026 |
It is part of: | Thorax, 2017 |
URI: | http://hdl.handle.net/2445/107161 |
Related resource: | http://dx.doi.org/10.1136/thoraxjnl-2016-209026 |
ISSN: | 0040-6376 |
Appears in Collections: | Articles publicats en revistes (ISGlobal) |
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