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| Participation in physical activity during center and home-based pulmonary rehabilitation for people with COPD: a secondary analysis of a randomized controlled trial |
| Lahham A, McDonald CF, Mahal A, Lee AL, Hill CJ, Burge AT, Cox NS, Moore R, Nicolson C, O'Halloran P, Gillies R, Holland AE |
| Journal of Cardiopulmonary Rehabilitation and Prevention 2019 Mar;39(2):E1-E4 |
| clinical trial |
| 4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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PURPOSE: To compare levels of physical activity during center and home-based pulmonary rehabilitation (PR) in people with chronic obstructive pulmonary disease. METHODS: Forty-five consecutive participants (23 male, n = 20, in the home-based group) with mean age of 68 +/- 8 yr and forced expiratory volume in the first second of expiration (FEV1) 53 +/- 18% predicted undertook physical activity monitoring using the SenseWear Armband during the final week of the interventions of center or home-based PR. Differences in time spent in total physical activity (>= 1.5 METs), time spent in moderate to vigorous intensity physical activity (>= 3 METs), and steps were compared. RESULTS: Home participants spent a median and interquartile range of 310 (199 to 328) min/d engaged in total physical activity (29% moderate to vigorous intensity physical activity) compared with 300 (204 to 370) min/d for the center group (28% moderate to vigorous intensity physical activity, p = 0.98). Daily step count did not differ between groups (home-based median 5232 (2067 to 7718) versus center-based median 4049 (1983 to 6040), p = 0.66). Of note, center-based participants took 38% more steps on days of program attendance compared with nonattendance days (mean difference 761 steps/d; 95% CI -56 to 1579, p = 0.06). CONCLUSION: For people with chronic obstructive pulmonary disease undertaking PR, no differences in physical activity levels between center and home-based programs were demonstrated. Understanding the impact of the indirect supervision and motivational interviewing technique utilized during home-based PR on levels of physical activity in people with chronic obstructive pulmonary disease may support clinical implementation of the model as an alternative option to traditional care.
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