BACKGROUND: Pulmonary rehabilitation (PR) is an essential element of chronic obstructive pulmonary disease (COPD) management. However, access to conventional face-to-face PR programmes is limited. METHODS: This multicentre, randomised controlled trial recruited patients with COPD from 18 sites in Germany and Switzerland, aiming to evaluate the impact of 12 weeks of a mobile app (intervention group; IVG) on quality of life, measured by COPD Assessment Test (CAT), and exercise capacity, assessed by 1-minute-sit-to-stand-test (1MSTST), compared with a control group (CTG) receiving 'enhanced standard-of-care'. RESULTS: 278 patients were included in the study with a median age of 65 years (IQR 60 to 70) and forced expiratory volume in 1 s 48% predicted (IQR 37 to 60). In the intention-to-treat analysis at week 12, CAT improved from baseline by median -4 points versus -3 points in the IVG versus CTG groups, respectively (difference 0 points (95% CI -1 to 2); p = 0.7); 1MSTST improved by 1 versus 2 repetitions, respectively (difference 1 repetition (95% CI 0 to 2); p = 0.12)). In a subset of the IVG, with patients grouped by application adherence (>= 3 days/week for >= 75% of the weeks), adherent users (40.4%) improved 1MSTST versus non-adherent users by median 2 repetitions (95% CI 1 to 3); p = 0.006. Application use did not raise any safety concerns. CONCLUSIONS: Application-based PR improved outcomes in COPD compared with baseline, and adherent users improved exercise capacity more compared with non-adherent users. Although not statistically significant compared with enhanced standard-of-care, this study may support the use of this application for COPD management and addresses the healthcare challenge of access to PR interventions. TRIAL REGISTRATION NUMBER: DRKS 00024390.
Reproduced with permission from the BMJ Publishing Group.

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