Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD.
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 18% predicted. Participants reported that logging their exercise and symptoms (FEV(1)) of 40 +/- 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.


BACKGROUND
ClinicalTrials.gov (NCT00373932).
Nguyen
Huong Q
HQ
University of Washington, Seattle, WA 98199, USA.
Gill
Dawn P
DP
Wolpin
Seth
S
Steele
Bonnie G
BG
Benditt
Joshua O
JO
D056044:Actigraphy / Q000295:instrumentation; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D040421:Cell Phone / Q000191:economics; D003362:Cost-Benefit Analysis; D005080:Exercise Test; D005081:Exercise Therapy / Q000191:economics; D005240:Feasibility Studies; D030141:Feedback, Psychological; D005260:Female; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D011788:Quality of Life; D020127:Recovery of Function; D012054:Reinforcement, Psychology; D012648:Self Care / Q000191:economics; D012720:Severity of Illness Index; D016896:Treatment Outcome