title: A telerehabilitation intervention for patients with Chronic Obstructive Pulmonary Disease: a randomized controlled pilot trial.
abstract: OBJECTIVE
  First, to investigate the effects of a telerehabilitation intervention on health status and activity level of patients with Chronic Obstructive Pulmonary Disease (COPD), compared to usual care. Second, to investigate how patients comply with the intervention and whether compliance is related to treatment outcomes.
  
  
  METHODS
  a randomized controlled pilot trial
  
  
  METHODS
  Thirty-four patients diagnosed with COPD.
  
  
  METHODS
  The telerehabilitation application consists of an activity coach (3D-accelerometer with smartphone) for ambulant activity registration and real-time feedback, complemented by a web portal with a symptom diary for self-treatment of exacerbations. The intervention group used the application for 4 weeks. The control group received usual care.
  
  
  METHODS
  Activity level measured by a pedometer (in steps/day), health status by the Clinical COPD Questionnaire at baseline and after intervention. Compliance was expressed as the time the activity coach was worn.
  
  
  RESULTS
  Fourteen intervention and 16 control patients completed the study. Activity level (steps/day) was not significantly affected by the intervention over time. There was a non-significant difference in improvement in health status between the intervention (-0.34±0.55) and control group (0.02±0.57, p=0.10). Health status significantly improved within the intervention group (p=0.05). The activity coach was used more than prescribed (108%) and compliance was related to the increase in activity level for the first two feedback weeks (r=0.62, p=0.03).
  
  
  CONCLUSIONS
  This pilot study shows the potential of the telerehabilitation intervention: compliance with the activity coach was high, which directly related to an improvement in activity levels.
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands Telemedicine Group, University of Twente, Enschede, The Netherlands m.tabak@rrd.nl.
authors.forename: Monique
authors.initials: M
authors.lastname: Tabak
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands Telemedicine Group, University of Twente, Enschede, The Netherlands.
authors.forename: Miriam Mr
authors.initials: MM
authors.lastname: Vollenbroek-Hutten
authors.affiliation: Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Paul Dlpm
authors.initials: PD
authors.lastname: van der Valk
authors.affiliation: Department of Research Methodology, Measurement and Data Analysis, University of Twente, Enschede, The Netherlands Medical School Twente, Medisch Spectrum Twente, Enschede, The Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
authors.affiliation: Roessingh Research and Development, Telemedicine Group, Enschede, The Netherlands Telemedicine Group, University of Twente, Enschede, The Netherlands.
authors.forename: Hermie J
authors.initials: HJ
authors.lastname: Hermens
mesh_terms: D061725:Accelerometry / Q000295:instrumentation / Q000379:methods; D000203:Activities of Daily Living; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D063731:Mobile Applications; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D009426:Netherlands; D010043:Outcome and Process Assessment, Health Care; D010865:Pilot Projects; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D000068997:Smartphone; D000069350:Telerehabilitation / Q000295:instrumentation / Q000379:methods*
keywords: Activities of daily living; Chronic Obstructive Pulmonary Disease (COPD); health status; telerehabilitation