Telemonitoring of home exercise cycle training in patients with COPD

Abstract

BackgroundRegular physical activity is associated with reduced mortality in patients with chronic obstructive pulmonary disease (COPD). Interventions to reduce time spent in sedentary behavior could improve outcomes. The primary purpose was to investigate the impact of telemonitoring with supportive phone calls on daily exercise times with newly established home exercise bicycle training. The secondary aim was to examine the potential improvement in health-related quality of life and physical activity compared to baseline.MethodsThis prospective crossover-randomized study was performed over 6 months in stable COPD patients. The intervention phase (domiciliary training with supporting telephone calls) and the control phase (training without phone calls) were randomly assigned to the first or the last 3 months. In the intervention phase, patients were called once a week if they did not achieve a real-time monitored daily cycle time of 20 minutes. Secondary aims were evaluated at baseline and after 3 and 6 months. Health-related quality of life was measured by the COPD Assessment Test (CAT), physical activity by the Godin Leisure Time Exercise Questionnaire (GLTEQ).ResultsOf the 53 included patients, 44 patients completed the study (forced expiratory volume in 1 second 47.5%±15.8% predicted). In the intervention phase, daily exercise time was significantly higher compared to the control phase (24.2±9.4 versus 19.6±10.3 minutes). Compared to baseline (17.6±6.1), the CAT-score improved in the intervention phase to 15.3±7.6 and in the control phase to 15.7±7.3 units. The GLTEQ-score increased from 12.2±12.1 points to 36.3±16.3 and 33.7±17.3.ConclusionTelemonitoring is a simple method to enhance home exercise training and physical activity, improving health-related quality of life.

Impact of a specific training programme on the neuromodulation of pain in female patient with fibromyalgia (DouFiSport): a 24-month, controlled, randomised, double-blind protocol

“…Patients will be contacted to record progress, difficulties and if necessary to encourage them to adhere to their programme. These calls will improve compliance and limit patients lost to follow-up 43 44. Subjects will note the characteristics (frequency, duration, intensity, type of activity and supervision) of each training session (both supervised and independent) in a specific training logbook.…”

Telemedicine in COPD: An Overview by Topics

“…Telemonitoring is not generally accepted yet because of a lack of compelling evidence of its beneficial long-term effects and, once again, the results obtained were mixed (Table 3). Studies report improvements in some outcomes assessed: quality of life [12,31], hospital readmissions at three months after discharge [41], and time to readmissions and all cause emergency department or hospital admissions [29,34]. Vianello, A., et al contradicts this information, with negative results in quality of life and a RCT with 578 patients intervened by Lilholt PH, et al exposed a non-superior health-related quality of life in a 12-months follow-up [32,33].…”

“…Other data suggests it might not have impact in reducing mortality and exacerbation-related outcomes in COPD [35], with others showing reticence regarding the application of these interventions in a generalized way (34), stating that the benefits might come from the fact that patients submitted to clinical trials have more attention and support with the disease than otherwise they would receive. Few reports also established positive results and possibilities for the successful application of telemonitoring interventions: with regard to noninvasive ventilation [38] forced expiratory volume [39], peripheral oxygen saturation [28,29,42] and physical activity [12]. There are also investigations into new technologies and telemonitoring methods with encouraging outcomes, such as, respiratory oscillometry [30,36,43], exhaled breath temperature [37] or telemonitoring machine learning that will enable treatments to be personalized and early detect COPD exacerbations [6,38,40].…”

Recommendation of physical activity for patients with severe COPD: an integrative review

“…Franke et al 9 44 patients diagnosed with moderate to very severe COPD participated in aerobic training with ergo metric bicycle at home for 20 minutes over 6 months…”

“…8 Even so, patients with severe COPD should be encouraged to exercise, since higher levels of physical activity are related to fewer hospitalizations, lower costs of treating the disease and less deaths. 9 It is known that cardiovascular exercises applied in pulmonary rehabilitation programs are capable of increasing the distance walked; improving cardiopulmonary performance and increasing the oxygen consumed in the peripheral muscles, 10 and although the evidence is still scarce, moderate to high-intensity training seems to present better results on lung capacity when compared to low intensity training. 11 This seems to have been evident in the work of Felcar et al 14 who applied moderate to high intensity training among patients treated in the aquatic environment and environment, and both groups presented an increase in the number of steps per day, improvement in maximum inspiratory and expiratory pressure levels, increase in maximum and sub-maximum functional capacity and quality of life scores.…”