A Pilot Feasibility Study of a Metronome-Cued mHealth System to Promote Walking Exercise in COPD

Objectives: This study was conducted to develop and evaluate a personalized, home-based metronome-cued walking mHealth system, tailored to individual exercise capacity, and assess its effects on physical activity and quality of life in patients with chronic obstructive pulmonary disease (COPD). Methods: A single-center prospective study was conducted in 40 patients with stable COPD, who were assigned to an intervention group (IG, n = 28) and a control group (CG, n = 12). The IG received a 12-week metronome-cued walking training through the mobile health system. The initial walking intensity was set at 70% of the patient's baseline level, as determined by the 6 min walking distance (6MWD) and cardiopulmonary exercise testing (CPET). The duration of the training was adjusted according to the Borg scale score and was conducted at least three times per week. The CG received standard care, including lifestyle advice, medications and dietary guidance. Outcomes, including the 6MWD, the COPD Assessment Test (CAT), the Clinical COPD Questionnaire (CCQ), the modified Medical Research Council (mMRC) dyspnea scale, and the Hospital Anxiety and Depression Scale (HADS), were recorded at baseline and week 12. Results: Among 40 enrolled patients, the IG showed improvements compared with the CG. The mean 6MWD increased by 35.32 m (95% CI: 27.84-42.80, p < 0.001) in the IG, with 68% of participants achieving the minimum clinically important difference (MCID) of +35 m. The CAT, the CCQ, the mMRC dyspnea scale, and the HADS also improved in the IG. These findings suggest that the intervention may improve exercise capacity, dyspnea, health-related quality of life and psychological well-being in this patient population. No intervention-related adverse events were observed during the study period. Conclusions: In this small, non-randomized pilot study, a personalized, home-based metronome-cued walking program supported by mHealth technology was feasible and showed preliminary signals of benefit for exercise capacity, dyspnea, quality of life and psychological well-being in patients with COPD.