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  • Using a smartphone application maintains physical activity following pulmonary rehabilitation in patients with COPD: a randomised controlled trial

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Chronic obstructive pulmonary disease
Original research
Using a smartphone application maintains physical activity following pulmonary rehabilitation in patients with COPD: a randomised controlled trial
  1. Marc Spielmanns1,2,
  2. Rainer Gloeckl3,4,
  3. Inga Jarosch3,4,
  4. Daniela Leitl3,4,
  5. Tessa Schneeberger3,4,
  6. Tobias Boeselt5,
  7. Stephan Huber6,
  8. Pawandeep Kaur-Bollinger6,
  9. Bernhard Ulm7,
  10. Claudia Mueller6,
  11. Jonas Bjoerklund6,
  12. Sabine Spielmanns1,
  13. Wolfram Windisch2,8,
  14. Anna-Maria Pekacka-Egli1,
  15. Andreas Rembert Koczulla3,4
  1. 1 Pulmonary Medicine, Zuercher RehaZentren Klinik Wald, Wald, Switzerland
  2. 2 Faculty of Health, Department for Pulmonary Medicine, University Witten Herdecke, Witten, Germany
  3. 3 Pulmonary Rehabilitation, Philipps-Universität Marburg, Marburg, Germany
  4. 4 Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
  5. 5 Pulmonary Medicine, Philipps University Marburg Faculty of Medicine, Marburg, Germany
  6. 6 Kaia Health GmbH, Munich, Bavaria, Germany
  7. 7 Unabhaengige Statistische Beratungen Bernhard Ulm, Munich, Bavaria, Germany
  8. 8 Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Koeln, Koeln, Germany
  1. Correspondence to Dr Marc Spielmanns, Pulmonary Medicine, Zürcher RehaZentren Hospital Wald, Wald, Switzerland; spielmanns{at}me.com

Abstract

Background Evidence suggests that patients with COPD struggle to maintain improved physical activity (PA) after completing pulmonary rehabilitation (PR). Smartphone applications (apps) providing a comprehensive training programme have conferred healthy benefits. This study was conducted to determine whether regular usage of an app maintains PA following PR.

Methods Patients with stage II–IV COPD were enrolled in a 6-month trial following PR. After the screening period, participants were randomised into the Kaia COPD app group (intervention group (IG)) or the control group (CG). The primary outcome was PA (daily steps), measured using an activity tracker. Secondary outcomes included the COPD Assessment Test (CAT), the Chronic Respiratory Disease Questionnaire (CRQ) and the 1 min Sit-to-Stand Test (STST).

Results Sixty participants completed the study. The median steps from baseline to 6 months were significantly different between the groups, in favour of the IG (−105.3, IQR −1970.1 to 2105.8, vs CG −1173.0, IQR −3813.1 to –93.8; p=0.007). CAT was significantly decreased in the IG (15.1±8.6 vs 19.7±6.4, p=0.02), whereas the CRQ subdomains for dyspnoea (4.5±1.7 vs 3.7±1.3, p=0.033) and fatigue (4.5±1.4 vs 3.5±1.3, p=0.028) improved significantly in the IG. The STST at 6 months was not significant. Sleep duration and sleep efficiency showed no significant differences between the two groups at any time.

Conclusions A comprehensive program by using the Kaia app following PR maintained PA and improved symptoms in patients with COPD at 6 months. The app might be an important accessory tool for enhanced COPD care.

Trial registration number DRKS00017275.

  • Pulmonary Rehabilitation
  • Exercise
  • COPD Pathology

Data availability statement

Deidentified and aggregated participant data are available from the corresponding author on reasonable request, subject to approval by an independent ethics committee.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

http://dx.doi.org/10.1136/thoraxjnl-2021-218338

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    Data availability statement

    Deidentified and aggregated participant data are available from the corresponding author on reasonable request, subject to approval by an independent ethics committee.

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    Footnotes

    • Contributors MS was the principal investigator for Switzerland and supervised the study, PR programme and data collection; ARK was the principal investigator for Germany. MS, TB, SH, PK-B, A-MP, SS, RG, IJ, TS, DL and ARK contributed to the study concept and design, as well as in the data collection. MS and SH wrote the first draft of the manuscript, which was critically reviewed by RG, PK-B, SS, ARK, WW, IJ, and TS. BU contributed for the statistical analysis. All authors participated in various steps in the study, edited the manuscript and gave their approval for submission. MS is the guarantor of the article.

    • Funding The clinical study was sponsored by Kaia Health software GmbH.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.