title: Physical activity is increased by a 12-week semiautomated telecoaching programme in patients with COPD: a multicentre randomised controlled trial.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  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.
  
  
  BACKGROUND
  NCT02158065.
authors.affiliation: KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.|University hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium.|IS Global, Center for research in Environmental epidemiology (CREAL), Barcelona, Spain.
authors.forename: H
authors.initials: H
authors.lastname: Demeyer
authors.affiliation: National and Kapodistrian University of Athens, Faculty of Physical Education and Sports Sciences Athens, GR.
authors.forename: Z
authors.initials: Z
authors.lastname: Louvaris
authors.affiliation: Department of Epidemiology, University of Zurich, Biostatistics and Prevention Institute, Zurich, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Frei
authors.affiliation: ELEGI Colt Laboratory, Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Rabinovich
authors.affiliation: GRIAC-Primary Care, department of general practice and elderly care, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands.|Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: de Jong
authors.affiliation: IS Global, Center for research in Environmental epidemiology (CREAL), Barcelona, Spain.|CIBER Epidemiologica y Salud Publica (CIBERESP), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Gimeno-Santos
authors.affiliation: KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.|University hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium.
authors.forename: M
authors.initials: M
authors.lastname: Loeckx
authors.affiliation: Royal Brompton and Harefiled NHS Foundation Trust and Imperial College, NIHR Respiratory Biomedical Research Unit, London, UK.
authors.forename: S C
authors.initials: SC
authors.lastname: Buttery
authors.affiliation: ELEGI Colt Laboratory, Centre for Inflammation Research, The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK.
authors.forename: N
authors.initials: N
authors.lastname: Rubio
authors.affiliation: GRIAC-Primary Care, department of general practice and elderly care, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands.|Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: Van der Molen
authors.affiliation: Royal Brompton and Harefiled NHS Foundation Trust and Imperial College, NIHR Respiratory Biomedical Research Unit, London, UK.
authors.forename: N S
authors.identifier: http://orcid.org/0000-0003-3235-0454
authors.initials: NS
authors.lastname: Hopkinson
authors.affiliation: National and Kapodistrian University of Athens, Faculty of Physical Education and Sports Sciences Athens, GR.|National and Kapodistrian University of Athens, Faculty of Physical Education and Sports Sciences Athens, GR.
authors.forename: I
authors.initials: I
authors.lastname: Vogiatzis
authors.affiliation: Department of Epidemiology, University of Zurich, Biostatistics and Prevention Institute, Zurich, Switzerland.
authors.forename: M A
authors.initials: MA
authors.lastname: Puhan
authors.affiliation: IS Global, Center for research in Environmental epidemiology (CREAL), Barcelona, Spain.|CIBER Epidemiologica y Salud Publica (CIBERESP), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Garcia-Aymerich
authors.affiliation: Royal Brompton and Harefiled NHS Foundation Trust and Imperial College, NIHR Respiratory Biomedical Research Unit, London, UK.
authors.forename: M I
authors.initials: MI
authors.lastname: Polkey
authors.affiliation: KU Leuven, Department of Rehabilitation Sciences, Leuven, Belgium.|University hospitals Leuven, Department of Respiratory Diseases, Leuven, Belgium.
authors.forename: T
authors.initials: T
authors.lastname: Troosters
mesh_terms: D000368:Aged; D015444:Exercise / Q000502:physiology*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D013147:Spirometry; D013557:Switzerland; D017216:Telemedicine; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Exercise; Pulmonary Rehabilitation