A randomised trial of a web-based physical activity self-management intervention in COPD

Area of Science:

• Pulmonary Medicine
• Digital Health
• Rehabilitation

Background:

• Chronic obstructive pulmonary disease (COPD) significantly impairs exercise capacity, leading to reduced physical activity and health-related quality of life (HRQoL).
• Self-management interventions, particularly technology-mediated ones, offer accessible support for individuals with COPD to manage their condition effectively.
• Web-based interventions show promise for promoting physical activity and improving self-management in chronic diseases.

Purpose of the Study:

• To evaluate the effectiveness of a web-based self-management intervention focused on physical activity promotion for improving exercise capacity in COPD patients.
• To assess the intervention's impact on secondary outcomes including physical activity levels, HRQoL, dyspnoea, COPD knowledge, and social support.

Main Methods:

• A 6-month randomized controlled trial (NCT02099799) involving 153 participants with COPD, allocated to a web-based intervention or usual care.
• The intervention included personalized step-count goals, feedback, online education, and a community forum.
• Primary outcome was exercise capacity measured by the 6-minute walk distance (6MWD); secondary outcomes included daily steps, HRQoL, and other relevant measures.

Main Results:

• No significant difference in the primary outcome (6MWD) between the intervention and usual care groups.
• Participants in the intervention group showed a significant increase in daily step counts (1312 more steps per day) compared to the usual care group (p<0.001).
• No significant differences were observed in other secondary outcomes, although engagement varied by study site.

Conclusions:

• The web-based self-management intervention effectively increased physical activity in individuals with COPD but did not improve exercise capacity.
• Further modifications to web-based interventions are necessary to enhance their effectiveness in COPD self-management and improve clinical outcomes.
• Technology-mediated interventions require optimization to fully realize their potential in supporting chronic disease management.