Physical activity enhancing programme (PAEP) in COPD – a randomised controlled trial

Background: There is a need to increase physical activity (PA) in COPD patients. A novel strategy is the combination of pulmonary rehabilitation (PR) with a coaching programme that provides patients with feedback on their activity levels and weekly targets. Objectives: To study the benefits of a web-based PAEP with set targets and feedback based on objectively measured PA in COPD patients attending PR. Methods: 44 COPD patients (22 males, 69±11years, FEV 1 54±19%pred, 3793±2209 steps/day) were assessed at baseline (Visit 1) and randomised to either receive a 12-week PAEP web-based human coaching together with an activity monitor (Tracmor D, Philips) with weekly targets and feedback while attending PR, or usual care (PR only). Both groups received the same PR programme. Patients repeated all the assessments performed at Visit 1 after 3 months (Visit 2), including: Endurance Shuttle Walking Test (ESWT), quadriceps maximal voluntary contraction (QMVC), anxiety/depression (HADS), quality of life (CAT) and PA levels (Actigraph GT3x). Results: Between the two visits, there were greater changes in PA levels, ESWT and QMVC in the PAEP group compared to usual care (1251±2408 vs -410±1118 steps/day; 99±139 vs 3±83 meters; 15±20 vs -5±18 N/m, p vs 5[3–8] and 3[2–6], Visit 1 vs Visit 2 respectively, p vs 16[8–20], p=0.001). Conclusions: A web-based PAEP making use of feedback and adaptive targets significantly improves PA, exercise capacity, muscle strength, quality of life and anxiety and depression in COPD patients attending PR.